Perimenopausal Hormone Replacement Treatments as a Geroprotective Approach - Adapting Clinical Guidance

Area of Science:

• Gerontology
• Reproductive Endocrinology
• Women's Health

Background:

• Ovarian endocrine function decline is central to female aging, preceding reproductive cessation.
• Hormone Replacement Therapy (HRT) is proposed as a geroprotective strategy targeting aging hallmarks.
• HRT is underutilized for its anti-aging potential despite clinical use.

Purpose of the Study:

• To review HRT's role as a geroprotective therapy in perimenopausal women.
• To highlight the need for biomarker-driven studies to validate HRT's geroprotective effects.
• To advocate for tailored clinical guidelines for HRT in perimenopause.

Main Methods:

• Narrative review of existing literature on HRT and aging.
• Focus on HRT initiated within 10 years of menopause onset.
• Emphasis on endocrine, inflammatory, and metabolic profiles of perimenopause.

Main Results:

• HRT has mechanistic relevance across the 12 hallmarks of aging.
• Prospective, biomarker-driven studies are necessary to confirm geroprotective efficacy.
• Current data suggests HRT's potential as an early intervention.

Conclusions:

• HRT can be a valuable geroprotective intervention for eligible perimenopausal women.
• Optimizing HRT requires age- and phase-specific biomarkers for precision care.
• Developing specific clinical guidelines is crucial for effective HRT implementation in perimenopause.