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The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
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Menopausal Hormone Therapy: a Comprehensive Review.

Gina Lundberg1, Pensee Wu2,3, Nanette Wenger4

  • 1Emory University School of Medicine, Emory Women's Heart Center, Atlanta, GA, USA. Gina.Lundberg@Emory.edu.

Current Atherosclerosis Reports
|June 20, 2020
PubMed
Summary
This summary is machine-generated.

Menopausal hormone therapy (MHT) is now considered safer for younger women, especially when initiated within 10 years of menopause. Newer, lower-dose, and transdermal options may reduce cardiovascular risks.

Keywords:
Atherosclerotic cardiovascular diseaseCardiovascular riskHormonesMenopauseSafety

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Area of Science:

  • Reproductive Endocrinology
  • Cardiovascular Medicine
  • Women's Health

Background:

  • Menopausal hormone therapy (MHT) was historically recommended for preventing cardiovascular disease and osteoporosis, based on observational data.
  • Large randomized trials revealed increased cardiovascular disease (CVD) risk in postmenopausal women using MHT, leading to decreased prescription rates.

Purpose of the Study:

  • To review current evidence on the safety and benefits of menopausal hormone therapy (MHT) for women.
  • To highlight updated guidelines and newer MHT formulations for managing menopause symptoms and associated risks.

Main Methods:

  • Review of recent randomized controlled trials and observational studies on MHT.
  • Analysis of sex-specific atherosclerotic cardiovascular disease (ASCVD) risk factors in women.
  • Evaluation of newer MHT routes, doses, and combinations, including SERMs.

Main Results:

  • MHT may be safe for younger women (within 10 years of menopause) using low-dose or transdermal options for short durations.
  • Newer MHT formulations and selective estrogen receptor modulators (SERMs) may offer a lower-risk profile.
  • Evidence-based guidelines now incorporate sex-specific ASCVD risk assessment for MHT use.

Conclusions:

  • Current evidence supports individualized MHT use in select postmenopausal women, focusing on early initiation and appropriate formulations.
  • Healthcare providers must be aware of updated MHT indications, contraindications, risks, and nonhormonal alternatives.
  • Personalized risk-benefit assessment is crucial for optimizing MHT in women.