Archive | 2019
Menopausal Hormone Therapy to Prevent Chronic Conditions
Abstract
The most efficient approach for relief of the vasomotor symptoms of the menopause at any age comprises MHT based on estrogens (alone or in combination with progestogens), tibolone, and the combination of conjugated estrogens and bazedoxifene. Randomized placebo-controlled trials have demonstrated that low-dose vaginal estrogen, intravaginal dehydroepiandrosterone, and oral ospemifene effectively improve vaginal comfort and trophism. Findings from randomized clinical trials, as well as preclinical, clinical, and epidemiologic studies, clarify the favorable benefit-risk profile for MHT use by recently menopausal women (also known as the timing hypothesis) with bothersome vasomotor and related menopausal symptoms. The window-of-opportunity theory has been extended to other putative benefits of hormone therapy, including reducing dementia, improving cognition, and preventing mood disorders. However, supporting evidence is limited. We must emphasize the individualization and shared decision-making that facilitates the appropriate decisions regarding the use of MHT.