Keywords
climacteric
hormone replacement therapy
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Abstract
Objective: To analyze the indications and benefits of Hormone Replacement Therapy (HRT) during the climacteric period. Literature Review: Menopause marks the decline in female reproductive function, defined by the absence of menstruation for at least 12 months, retrospectively, which occurs due to primary ovarian insufficiency, generally between the ages of 45 and 55. In addition to increasing the risk of chronic conditions, such as cardiovascular disease, a lack of estrogen during this period is also associated with osteoporosis. This review's main objective is to analyze the indications and benefits of hormone replacement therapy in menopause. In this scenario, HRT constitutes an efficient approach for the management of vasomotor and genitourinary symptoms that occur at this stage, in addition to presenting benefits on the cardiovascular and bone health of women who are in the window of opportunity. Despite this, hormonal therapy may have contraindications, such as use in patients with a family history of breast and endometrial cancer, for example. Final Considerations: This therapy must be individualized, considering personal preferences and appropriate clinical indications, in order to maximize its benefits.
References
ARMENI E, et al. Hormone therapy regimens for managing the menopause and premature ovarian insufficiency. Best Practice & Research Clinical Endocrinology & Metabolism, 2021; 35(6):101561.
BACCARO LFC, et al. Initial Evaluation in the Climacteric. Revista Brasileira de Ginecologia e Obstetrícia, 2022; 44(5): 548–556.
BELÉM GLS, et al. Riscos e benefícios da terapia hormonal no climatério. Revista Eletrônica Acervo Saúde, 2019; 11(4): e244.
CHO L, et al. Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?. Circulation, 2023; 147(7): 597–610.
COSTA LLA, et al. Benefits and indications of hormone therapy for women in menopause: An integrative literature review. Research, Society and Development, 2024; 13(5): e4313545789.
DO CARMO IA, et al. Indicações e contraindicações do uso de terapia de reposição hormonal. Brazilian Journal of Health Review, 2023; 6(5): 24279-24286.
FAUBION SS, et al. The 2020 Genitourinary Syndrome of Menopause Position Statement of The North American Menopause Society. Menopause: The Journal of The Menopause Society, 2020; 27(9): 976–992.
FLORES VA, et al. Hormone Therapy in Menopause: Concepts, Controversies, and Approach to Treatment. Endocrine Reviews, 2021; 42(6): 720–752.
GENAZZANI A, et al. Hormone therapy in the postmenopausal years: considering benefits and risks in clinical practice. Human Reproduction Update, 2021; 27(6): 1115–1150.
GONÇALVES, RF, et al. Relação Do Estrogênio Com A Osteoporose Em Mulheres Menopausadas. Caderno Verde de Agroecologia e Desenvolvimento Sustentável, 2019; 9: 3.
GOSSET A, et al. Menopausal hormone therapy for the management of osteoporosis, Best practice & research. Clinical endocrinology & metabolism, 2021; 35(6):101551.
HARPER-HARRISON G, SHANAHAN MM. Hormone Replacement Therapy. StatPearls, 2023.
JASPERS L, et al. Health in middle-aged and elderly women: A conceptual framework for healthy menopause. Maturitas, 2015; 81(1):93-8.
KARLAMANGLA AS, et al. Bone Health During the Menopause Transition and Beyond. Obstetrics and gynecology clinics of North America, 2018; 45(4):695-708. doi:10.1016/j.ogc.2018.07.012
LORITE MI, et al. Benefits for cardiovascular system, bone density, and quality of life of a long-term hormone therapy in hysterectomized women: a 20-year follow-up study. Menopause: The Journal of The Menopause Society, 2023; 30(10): 995-1001.
MEHTA J, et al. Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts. Frontiers in endocrinology, 2021; 12(1):564781.
MINKIN MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstetrics and Gynecology Clinics of North America, 2019; 46(3): 501–514.
NA Z, et al. Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis. Open Life Sciences, 2023; 18(1): 20220759.
SANTORO N, et al. The Menopause Transition: Signs, Symptoms, and Management Options. The Journal of Clinical Endocrinology & Metabolism, 2021; 106(1): 1–15.
SARMENTO ACA, et al. Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review. Revista Brasileira de Ginecologia e Obstetrícia, 2022; 44(10): 986–994.
SHIH Y, et al. Menopausal hormone therapy decreases the likelihood of diabetes development in peri-menopausal individuals with prediabetes. Diabetes & metabolism, 2024; 50(4): 101546.
TALAULIKAR V. Menopause transition: Physiology and symptoms. Best practice & research. Clinical obstetrics & gynaecology, 2022; 81(1): 3-7.
TRÉMOLLIERES FA, et al. Management of postmenopausal women: Collège National des Gynécologues et Obstétriciens Français (CNGOF) and Groupe d’Etude sur la Ménopause et le Vieillissement (GEMVi) Clinical Practice Guidelines. Maturitas, 2022; 163: 62–81.
YONG EL e LOGAN S. Menopausal osteoporosis: screening, prevention and treatment. Singapore medical journal, 2021; 62(4):159-166.