[New aspects of hormone replacement therapy]

Area of Science:

• Menopause and Women's Health
• Endocrinology
• Cardiovascular Health

Background:

• Current guidelines recommend hormone replacement therapy (HRT) as the primary treatment for acute menopausal symptoms.
• Low-dose vaginal therapy is the preferred approach for managing urogenital atrophy and its associated issues.
• The timing of HRT initiation may influence its cardiovascular impact.

Purpose of the Study:

• To review the established recommendations and evidence regarding hormone replacement therapy (HRT) in postmenopausal women.
• To evaluate the efficacy of HRT in managing acute climacteric syndrome and preventing osteoporosis.
• To assess the influence of early HRT initiation on ischemic heart disease and discuss long-term therapy considerations.

Main Methods:

• Review of existing clinical guidelines and relevant scientific literature.
• Analysis of data concerning the effects of HRT on climacteric symptoms, urogenital atrophy, and osteoporosis.
• Evaluation of studies investigating the cardiovascular effects of HRT, particularly concerning ischemic heart disease.

Main Results:

• HRT is consistently recommended as the first-line therapy for acute climacteric syndrome.
• Low-dose vaginal HRT is effective for preventing and treating urogenital atrophy.
• Early initiation of HRT appears to have a neutral or slightly beneficial effect on ischemic heart disease.
• HRT is confirmed as effective in preventing and treating postmenopausal osteoporosis.

Conclusions:

• HRT remains a cornerstone in managing acute menopausal symptoms and preventing postmenopausal osteoporosis.
• The benefits of early HRT on cardiovascular health warrant consideration.
• Individualized assessment of the benefits-to-risks ratio is crucial for determining the appropriateness and duration of long-term HRT, considering different HRT formulations.