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Review
. 2021 Mar 26:12:564781.
doi: 10.3389/fendo.2021.564781. eCollection 2021.

Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts

Jaya Mehta  1 , Juliana M Kling  2 , JoAnn E Manson  3
Affiliations
Review

Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts

Jaya Mehta et al. Front Endocrinol (Lausanne). .

Abstract

Menopausal hormone therapy (HT) prescribing practices have evolved over the last few decades guided by the changing understanding of the treatment's risks and benefits. Since the Women's Health Initiative (WHI) trial results in 2002, including post-intervention analysis and cumulative 18-year follow up, it has become clear that the risks of HT are low for healthy women less than age 60 or within ten years from menopause. For those who are experiencing bothersome vasomotor symptoms, the benefits are likely to outweigh the risks in view of HT's efficacy for symptom management. HT also has a role in preventing osteoporosis in appropriate candidates for treatment. A comprehensive overview of the types, routes, and formulations of currently available HT, as well as HT's benefits and risks by outcomes of interest are provided to facilitate clinical decision making.

Keywords: estrogen; hot flashes; menopausal hormone therapy; post-menopause; progesterone.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Relative risks (and 95% confidence intervals) for coronary heart disease events associated with hormone replacement therapy from meta-analysis of 23 randomized controlled trials in 39,049 women (followed for 191,340 women-years). (B) Relative risks (and 95% confidence intervals) for total mortality associated with hormone replacement therapy from meta-analysis of 30 randomized controlled trials in 26,708 women (followed for 119,118 women-years). *Figure used with permission by John Wiley and Sons (License: 4838400238207) and from Dr. Howard Hodis from Hodis HN, Mack WJ. The timing hypothesis: a paradigm shift in the primary prevention of coronary heart disease in women: part 1, comparison of therapeutic efficacy. J Am Geriatr Soc. 2013;61(6):1005-1010..
See this image and copyright information in PMC

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