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Feature Article

Menopausal hormone therapy: current recommendations

Madhuni Herath, Beverley Vollenhoven

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© HIGHWAYSTARZZ-PHOTOGRAPHY/ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Menopausal hormone therapy (MHT) has proven benefit in reducing vasomotor and vulvovaginal symptoms and fracture rates in menopausal women. However, since the publication of the Women’s Health Initiative study findings in 2002 and 2004, use of MHT has declined. This article aims to alleviate concerns around the use of MHT by providing an evidence-based review of the available literature comparing the benefits and risks of MHT use in its different formulations.

Key Points

  • Menopause can be characterised by vasomotor and vulvovaginal symptoms as well as sleep difficulties and mood disorders.
  • Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and also alleviates vulvovaginal symptoms.
  • Controversies around MHT have resulted in reduced use of this therapy.
  • MHT is recommended for women less than 60 years of age within 10 years of menopause.
  • Local estrogen therapy is recommended for women with vulvovaginal symptoms in the absence of vasomotor symptoms.
  • MHT is currently not recommended for use in the prevention of cardiovascular disease or dementia.

Figures

© HIGHWAYSTARZZ-PHOTOGRAPHY/ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY
© HIGHWAYSTARZZ-PHOTOGRAPHY/ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY