How long is the appropriate duration to determine that the hormone
therapy is ineffective in menopause?
As a general rule in pharmacotherapy, ineffective pharmacological
treatment should be discontinued. Ineffective pharmacotherapy should not
be administered for a long time. The first problem is the appropriate
duration to determine that the pharmacological treatment is ineffective.
The second problem is the criterion for determining the efficacy (or
ineffectiveness) of the pharmacological treatment. As far as I know,
there is no evidence regarding the duration. Nevertheless, it is
necessary to determine the duration. Standards by academic organizations
are necessary, even provisional standards are acceptable. Long-term
administration of ineffective medicine causes the problem of adverse
effects. It loses the opportunity to receive effective treatment. In
case that HT is ineffective for menopause, the treatment of fibromyalgia
may relieve symptoms of menopause. Patients do not get medical attention
for the improvement of abnormal hormone levels but do for the
improvement of subjective symptoms such as widespread pain, numbness,
insomnia, and fatigue. Some people are almost asymptomatic even if their
hormone levels are abnormal. I believe that the efficacy (or
ineffectiveness) should be determined with the improvement of the
above-mentioned subjective symptoms rather than the improvement of the
abnormal hormone levels.