Hormone therapy for first-line management of menopausal symptoms: Practical recommendations

Abstract

Hormone therapy use has undergone dramatic changes over the past 20 years. Widespread use of hormone therapy in the 1980s and 1990s came to an abrupt halt in the early 2000s after initial findings of the Women’s Health Initiative trial were published and the study was terminated. Since then, much has been learned about the characteristics of women most likely to benefit from hormone therapy. There is general agreement that women younger than 60 years or who initiate hormone therapy within 10 years of menopause onset gain short-term benefit in terms of symptomatic relief and long-term benefit in terms of protection from chronic diseases that affect postmenopausal women. Despite accumulating evidence in support of hormone therapy for symptomatic menopausal women, the slow response by the medical community has led to a ‘large and unnecessary burden of suffering’ by women worldwide. Greater efforts are clearly needed to educate physicians and medical students about the pathophysiology of menopause and the role of hormone therapy in supporting women through the transition. This article provides a brief historical perspective of events that led to the backlash against hormone therapy, explores the current position of guideline groups, and provides practical recommendations to guide first-line management of symptomatic menopausal women.

Progesterone decreases apnoea and reduces oxidative stress induced by chronic intermittent hypoxia in ovariectomized female rats

“…Sleep apnoea and CIH after menopause have immediate (poor sleep quality) and long‐term (cardiovascular, metabolic, and neurological morbidity and mortality) consequences on women's health. Optimal and personalized hormonal therapy remains an essential tool for adequate management of menopausal symptoms, and treatment might combine oestrogens and/or progesterone in line with current practice and guidelines (Palacios, Stevenson, Schaudig, Lukasiewicz, & Graziottin, 2019). Since sleep apnoea increases at menopause, hormone therapy might also be beneficial against the consequences of sleep apnoea.…”

Physiologically Active Molecules and Functional Properties of Soybeans in Human Health—A Current Perspective

“…In the United States, approximately 15% of women who have entered menopause receive estrogen administration as hormone therapy [ 53 ]. However, estrogen administration increases the likelihood of cancer in reproductive organs [ 54 ]; thus, soybean, a natural food, is gradually being considered as a potential substitute for estrogen in this population [ 6 ].…”

Understanding Hormonal Therapies: Overview for the Dermatologist Focused on Hair

“…Progestogens are subdivided into two types: natural progestogen (progesterone itself) and synthetic progestogens (collectively known as progestins). Synthetic progestins are further classified based on their structural similarity to either testosterone, progesterone or spironolactone [5,14,15], and they pertain to one of four "generations" [2,4,8,16] (Table 1).…”