Transdermal Hormonal Therapy in Menopause: Current Evidence and Personalized Approaches

Maintaining hormonal equilibrium is a key determinant of women's health, particularly during the menopausal transition and postmenopause. The decline in ovarian estrogen and progesterone production influences multiple physiological systems, affecting many aspects like vasomotor stability, bone and cardiovascular health, cognitive function, mood, and metabolic regulation. As a result, many women may experience symptoms that impair daily functioning and increase long-term morbidity. Recent progress in menopausal care emphasizes individualized, evidence-guided treatment, supported by improved diagnostic tools that allow for a more precise assessment of endocrine changes during this life stage. Among the available therapeutic options, transdermal menopausal hormone therapy has gained growing recognition due to its ability to re-establish hormonal levels with fewer systemic effects. By bypassing first-pass hepatic metabolism, this route provides more consistent serum hormone concentrations and may be associated with a lower risk of metabolic and thromboembolic complications compared with oral formulations. This review brings together the physiological basis, clinical indications, and current scientific evidence related to transdermal hormonal therapy during menopause while also highlighting its expanding therapeutic role and integration into personalized treatment strategies. In addition, we discuss recent findings on its pharmacological profile, clinical effectiveness, and emerging perspectives that position this therapeutic option as an increasingly important component of modern menopausal care and women's health management.