Reconsidering Hormone Replacement Therapy: Current Insights on Utilisation in Premenopausal and Menopausal Women: An Overview

Переосмысление заместительной гормональной терапии: современные представления о применении у женщин в пременопаузе и менопаузе: обзор
Vesselina Yanachkova, Mariela Vasileva‐Slaveva, Stoyan Kostov, Angel Yordanov
2025-10-10

hormone replacement therapymenopausal symptomsosteoporosis preventionurogenital symptomsvasomotor symptoms
Hormone replacement therapy (HRT) has been utilized in clinical practice for decades as a main therapeutic approach for mitigating menopausal symptoms. The symptoms mostly encompass vasomotor and genitourinary issues resulting from the deficiency of estrogen and progesterone. Initially identified as a universally advantageous and indispensable intervention, hormone replacement therapy subsequently became the subject of considerable scientific and clinical debate, especially after the publication of extensive epidemiological studies indicating potential adverse effects associated with cardiovascular and cancer risk. This study aims to reassess the role of HRT in clinical practice by analyzing its historical evolution, expanded clinical uses, and changes in guidelines necessitated by resent scientific studies. Current evidence from clinical studies and meta-analyses unequivocally demonstrates that hormone replacement therapy is the most efficacious treatment for vasomotor and urogenital symptoms, and also acknowledging its potential role in osteoporosis prevention. The administration of HRT requires careful individual assessment, considering the patient's age, timing of initiation, existence of comorbidities. In this setting, therapy decisions have to be based on a combination of the most up-to-date clinical guidelines, risk stratification, and the patient's preferences. In conclusion, the assessment of HRT confirms its primary role in reducing menopausal symptoms while also highlighting the imperative for a individual strategy that balances benefits and risks to improve outcomes for women.
1
Current evidence supports a potential role for hormone replacement therapy in preventing osteoporosis.
2
Earlier perceptions of universally beneficial HRT shifted after studies raised concerns about cardiovascular and cancer risks.
3
HRT decisions should be individualized according to age, initiation timing, comorbidities, updated guidelines, risk stratification, and patient preferences.
4
Hormone replacement therapy is identified as the most efficacious treatment for menopausal vasomotor and urogenital symptoms.
5
The overall benefit–risk assessment supports HRT’s primary role in symptom reduction while requiring careful personalized management.

Hormone replacement therapy (HRT) in premenopausal and menopausal women

The clinical efficacy, uses, benefits, risks, and individualized treatment-guideline considerations of HRT for menopausal symptom relief and osteoporosis prevention

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2025-10-10
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Vesselina Yanachkova
Mariela Vasileva‐Slaveva
Stoyan Kostov
Angel Yordanov
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