Menopause

The menopausal transition and menopause are significant events in women's lives. They serve as identifiable markers of a woman's aging, and they often herald other health, psychosocial, and cultural changes, often with negative consequences. After a full medical evaluation, management should include assessing the woman's views on menopause, addressing individual concerns, advising women about treatment options, and setting realistic goals from a prescribed management plan. Hormone therapy (HT) is an option for the distressing vasomotor and urogenital symptoms experienced by some women during the menopausal transition and the menopause as well as an option for some women at risk for fracture. It has been the principal treatment of menopause-related symptoms for over 50 years. The goal of HT is to adequately treat distressing symptoms of menopause with the lowest effective dose and the shortest duration of treatment. Hormone therapies differ by route of administration and formulation. HT can be administrated orally, transdermally, or locally. Hormone therapy is available as estrogen-only (ET) or estrogen-progesterone treatment (EPT). The primary indication for the addition of progesterone is to reduce the risk of endometrial cancer that occurs with unopposed estrogen. In addition, some studies have shown that the use of progesterone with low-dose estrogen may be more effective in treating vasomotor symptoms than estrogen-only formulations.