Hormone Therapy Impacts on Postmenopausal Health

Hormone therapy for postmenopausal women typically involves systemic oestrogen alone or combined oestrogen–progestogen preparations. It remains the most effective intervention for vasomotor symptoms and has demonstrated benefits for bone mineral density and fracture prevention. However, its risk–benefit profile is highly dependent on formulation, route of administration, timing relative to menopause onset and individual patient factors. Oral preparations have been linked with an elevated risk of venous thromboembolism and stroke, whereas transdermal delivery appears to maintain cardiovascular safety. Combined regimens confer a greater risk of breast malignancy than oestrogen alone, with absolute risk rising with duration of use. Emerging non-hormonal therapies, such as neurokinin 3 receptor antagonists, offer targeted relief of hot flushes without systemic hormone exposure. A personalised strategy guided by symptom severity, baseline risk and patient preference is essential to optimise quality of life and long-term health outcomes across diverse populations.

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Hormone Therapy Impacts on Postmenopausal Health publication trend

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Technical terms

Hormone replacement therapy (HRT): Systemic administration of oestrogen, with or without progestogen, to alleviate menopausal symptoms and prevent bone loss.

Venous thromboembolism: Formation of blood clots in a vein, encompassing deep vein thrombosis and pulmonary embolism.

Vasomotor symptoms: Fluctuating episodes of heat sensation and sweating commonly known as hot flushes and night sweats.

Transdermal delivery: Administration of medication through the skin, bypassing first-pass hepatic metabolism.

Neurokinin 3 receptor antagonist: A non-hormonal agent that blocks neurokinin B signalling to reduce menopausal flushing.

References

1. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. The Lancet (2019).
2. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. The BMJ (2019).
3. Neurokinin 3 receptor antagonism as a novel treatment for menopausal hot flushes: a phase 2, randomised, double-blind, placebo-controlled trial. The Lancet (2017).
4. Use of hormone replacement therapy and risk of breast cancer: nested case-control studies using the QResearch and CPRD databases. The BMJ (2020).