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Related Concept Videos

Menopause01:28

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Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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Hormonal Regulation of the Menstrual Cycle01:22

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The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
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Hormonal Regulation01:40

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Hormonal Regulation01:33

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The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
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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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Gonadal and Placental Hormones01:24

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The gonads, namely the testes in males and the ovaries in females, are pivotal in producing gonadal hormones that orchestrate the intricate processes of sexual development and reproduction.
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Related Experiment Video

Updated: May 7, 2026

An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
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Clinical Indicators for Perimenopausal Hormone Replacement Therapy: An Evidence-Based Narrative Review.

Y Luo1,2, M Liang1,2, Y Gao2,3

  • 1Shanxi Province Key Laboratory Cultivation Base Jointly Established by the Department and City of Hormone Metabolic Diseases during Perimenopause, Datong, Shanxi Province, P.R. China.

Nigerian Journal of Clinical Practice
|May 5, 2026
PubMed
Summary

This review simplifies perimenopausal hormone replacement therapy (HRT) decisions by evaluating key indicators. A tiered approach using standard tests for routine care and advanced biomarkers for complex cases enhances safety and cost-effectiveness.

Keywords:
Biomarkerscardiovascular diseasescost-benefit analysishormone replacement therapyosteoporosisperimenopause

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Area of Science:

  • Reproductive Endocrinology
  • Clinical Biochemistry
  • Women's Health

Background:

  • Clinical guidance for perimenopausal hormone replacement therapy (HRT) is inconsistent globally.
  • Clinicians face challenges balancing HRT safety with testing burdens and costs.
  • Effective decision-making requires evaluating various indicators for perimenopausal management.

Purpose of the Study:

  • To conduct a narrative review on the clinical utility of key indicators in perimenopausal HRT decision-making.
  • To summarize evidence on hormonal, skeletal, and cardiometabolic markers.
  • To propose a practical, cost-effective tiered evaluation framework for HRT assessment.

Main Methods:

  • Evidence-based narrative review of studies from PubMed, Web of Science, and Scopus (2014-2025).
  • Keywords included perimenopause, HRT, biomarkers, clinical decision-making, and risk stratification.
  • Focused on hormonal, skeletal, cardiometabolic indicators, imaging, and symptom measures.

Main Results:

  • Follicle-stimulating hormone (FSH) and estradiol aid staging but have limitations due to fluctuations.
  • Combining bone mineral density with bone turnover markers (β-CTX, PINP) improves fracture risk assessment.
  • Lipid profiles and inflammatory markers (e.g., C-reactive protein) aid cardiometabolic safety evaluation.

Conclusions:

  • A tiered evaluation framework is proposed: standard tests for routine assessment, advanced biomarkers for high-risk cases.
  • This approach supports practical clinical assessment and cost-effectiveness, especially in resource-limited settings.
  • The framework complements, rather than replaces, individualized clinical judgment in perimenopausal HRT management.