[Menopause: where are we three years beyond WHI?].

Area of Science:

• Endocrinology
• Oncology
• Women's Health

Context:

• The Women's Health Initiative (WHI) study significantly impacted the understanding and application of Menopausal Hormonal Therapy (HT).
• Extensive research has since explored HT's complex relationship with cardiovascular health and breast cancer risk.
• Evolving clinical practice necessitates updated guidelines for safe and effective HT use.

Purpose:

• To re-evaluate the role of Menopausal Hormonal Therapy in light of updated scientific evidence.
• To clarify the risks and benefits of HT concerning cardiovascular outcomes and breast cancer.
• To provide evidence-based recommendations for the appropriate use of HT in managing menopausal symptoms.

Summary:

• Menopausal Hormonal Therapy (HT) is contraindicated for cardiovascular prevention.
• Breast cancer risks associated with HT are dependent on treatment type and patient population.
• Current indications for HT are limited to recently menopausal women or those with debilitating symptoms.
• The recommended regimen involves trans-cutaneous estrogens combined with natural oral progesterone.
• Individualized patient assessment, considering personal preferences and expectations, is crucial for HT prescription.

Impact:

• Provides updated guidance on Menopausal Hormonal Therapy, emphasizing individualized treatment strategies.
• Helps clinicians make informed decisions regarding HT prescription, balancing symptom relief with potential risks.
• Contributes to safer and more effective management of menopausal symptoms in women.