New trends in current menopausal hormone therapy

Abstract

The article presents the results of recent studies on the effectiveness, safety and duration of menopausal hormone therapy (MHT). The main cardio-metabolic risk factors for cardiovascular diseases are formed in women precisely during the transition to menopause and are clearly associated with the appearance of vegetative menopausal symptoms and the development of endothelial dysfunction, which is a predictor of future serious health problems, especially cardiovascular diseases. The results of a number of epidemiological studies have shown that in women with severe climacteric manifestations, especially with hot flashes, the overall risk of developing cardiovascular diseases is increased. The need for early initiation of MHT is an indisputable truth and is not disputed by anyone, but the formed tendency to discontinue treatment in 56 years raises many questions among patients and their doctors. However, recent guidelines from the International Menopause Society state that there is no reason to arbitrarily limit the duration of MHT. This paper presents current evidence on the indications and benefits of low and ultra-low doses of MHT. In view of the high efficacy and safety of low doses of MHT, they seem to be the most acceptable starting doses of oral MHT for most women. In addition, women with early menopause should also receive higher doses of estrogens, as they are more physiological for them. The choice in favor of starting MHT in a postmenopausal woman with a low or ultra-low dose in each case should be selected individually.