Menopausal hormone therapy: a better and safer future.

Area of Science:

• * Reproductive Endocrinology and Women's Health

Background:

• * Menopause hormone therapy (MHT) is evolving with new research.
• * Current MHT approaches aim to improve safety and efficacy for menopausal women.

Purpose of the Study:

• * To outline recent significant advances in menopause hormone therapy.
• * To discuss the benefits and risks associated with new MHT strategies.

Main Methods:

• * Review of current research on the 'critical window' for MHT initiation.
• * Evaluation of transdermal estrogen delivery versus oral administration.
• * Assessment of micronized progesterone (MP) and levonorgestrel-releasing intrauterine devices (LNG-IUDs) in MHT.

Main Results:

• * Transdermal estrogen reduces venous thromboembolism risk compared to oral estrogen.
• * Micronized progesterone (oral and vaginal) shows promise in preventing endometrial hyperplasia without increasing breast cancer risk.
• * LNG-IUDs offer contraception and reduced uterine bleeding in perimenopausal women, but breast cancer risks need further clarification.

Conclusions:

• * Future MHT offers improved safety and benefits for women.
• * Personalized MHT strategies are emerging, focusing on the 'window of opportunity' and route of administration.
• * Further research is needed to establish long-term effects and clarify risks for certain MHT methods.