FIGO-WHF Guidance Advances Personalised Menopause Care for Women

By: Women Entrepreneurs Review Team | Wednesday, 7 October 2026

Women with cardiovascular risk factors or existing heart disease may need a more personalised approach to menopause hormone therapy (MHT), according to a new position paper released by the International Federation of Gynecology and Obstetrics (FIGO) and the World Heart Federation (WHF). Published in the International Journal of Gynecology & Obstetrics (IJGO), the paper brings together guidance from gynaecology and cardiology to help doctors make more informed decisions about menopause treatment.

The paper, titled “Menopause hormone therapy in women with cardiovascular risk factors or established ischemic heart disease: A joint FIGO and WHF position paper”, addresses women who are considering taking systemic MHT as well as having cardiovascular concerns. It reminds women to take into account the timing of treatment, the dosage and hormone type, and the woman’s personal health risks before beginning treatment.

Key Highlights

• FIGO-WHF paper offers new guidance on personalised menopause care
• Transdermal oestrogen preferred for women with cardiovascular risks
• Experts call for closer coordination between heart and menopause care

Early initiation of MHT (beginning shortly after menopausal onset and within 10 years of last period) might provide greater benefit, according to the paper. The decision to initiate treatment, however, should depend on various other criteria such as the woman's age, length of time since menopause, general health and cardiovascular risk.

For women with a high risk of blood clots, transdermal oestrogen is recommended and micronised progesterone or dydrogesterone is used if needed. Women who have previously been diagnosed with ischaemic heart disease may also be eligible for systemic MHT, to control menopausal symptoms, after careful review of the potential benefits and risks. On this basis, transdermal oestrogen, either alone or combined with micronised progesterone or dydrogesterone if needed, is offered to these women as the preferred treatment.

The guidance also emphasises that measures to prevent and/or manage cardiovascular disease should not be used in place of MHT. For women who need primary and/or secondary prevention, including statin therapy as needed, they should receive these preventive interventions in addition to the appropriate management of menopause.

A key point emphasized in the paper is the importance of improved collaboration between medical specialties in cases of complex health situations involving women. Other health care providers, such as a cardiologist, a gynaecologist, internist or primary care professional, can be part of the health care team when evaluating a woman's health and helping her make decisions about treatment.

Professor Chiara Benedetto, lead author of the paper, Dr Suvarna Kadhilkar, Chair of the FIGO Committee on Women at Menopausal Age and Dr Athena Poppas, WHF Trustee, emphasized the need for an integration of gynaecological and cardiovascular knowledge.

The position paper 'defines a common ground between gynaecologists and cardiologists' to help the two specialties deliver evidence-based and consistent counselling, the experts said. They also made it clear that sometimes conflicting advice can lead to the loss of treatment opportunities. They emphasized that a well-prescribed cardiac evaluation and personalized therapy should enable clinicians to determine an appropriate risk/benefit ratio for MHT.

The new guidance reflects a shift towards considering menopause in the context of a woman's broader health and not as a set of symptoms. The FIGO–WHF paper will enable the clinician to offer treatment that will better meet the needs of the individual woman, as cardiovascular health will be taken into account with menopausal symptoms and medical history.

The information underlines the need to consider specific risks and treatments for women who are experiencing menopause in combination with cardiovascular issues, and to talk with health care providers about the individual circumstances.