Keywords
Postmenopause
Hormone replacement therapy
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Abstract
Objective: To explore the available scientific evidence on the action of transdermal hormone therapy on clinical and laboratory parameters associated with cardiovascular risk in postmenopausal women.
Methods: This integrative review was developed using PICO strategy criteria and conducted through searches of the PubMed Central (PMC), CAPES Journal, and Virtual Health Library (VHL) databases, using the descriptors "Hormone Replacement Therapy," "Postmenopause," and "Cardiovascular Diseases" in combination with the Boolean term "AND." From this search, 3,282 articles were analyzed, and after applying inclusion and exclusion criteria, 18 articles were selected for this article. Results: Transdermal hormone therapy has shown benefits on endothelial function, lipid profile, inflammatory markers, and cardiovascular risk, with a lower thrombotic risk compared to the oral route, and its effects are more favorable when initiated early. However, data are still limited and heterogeneous, making definitive conclusions difficult. Final considerations: Transdermal hormone therapy is a promising option for reducing postmenopausal cardiovascular risk, but more robust studies are still needed to validate its efficacy and guide individualized use.
References
ABDOUN K, et al. Effect of early menopause and hormone replacement therapy on Aortic Stenosis progression. The Canadian Journal of Cardiology, 2025; 1: 10.
BALASUBRAMANIAN R, et al. Metabolomic effects of hormone therapy and associations with coronary heart disease among postmenopausal women. Circulation: Genomic and Precision Medicine, 2020; 13(6): e002977.
BLONDON M, et al. Comparative venous thromboembolic safety of oral and transdermal postmenopausal hormone therapies among women Veterans. Menopause (New York, N.Y.), 2021; 28(10): 1125–1129.
BONTEMPO S, et al. Use of MHT in women with cardiovascular disease: a systematic review and meta-analysis. Climacteric: The Journal of the International Menopause Society, 2024; 27(1): 93–103.
EL KHOUDARY SR, et al. Menopause transition and cardiovascular disease risk: Implications for timing of early prevention: A scientific statement from the American Heart Association. Circulation, 2020; 142(25): e506–e532.
GOLDŠTAJN MŠ, et al. Effects of transdermal versus oral hormone replacement therapy in postmenopause: a systematic review. Archives of Gynecology and Obstetrics, 2023; 307(6): 1727–1745.
GU Y, et al. The benefits and risks of menopause hormone therapy for the cardiovascular system in postmenopausal women: a systematic review and meta-analysis. BMC Women's Health, 2024; 24(1): 60.
HILSER JR, et al. Effect of menopausal hormone therapy on methylation levels in early and late postmenopausal women. Clinical Epigenetics, 2022; 14(1): 90.
HODIS HN, MACK WJ. Menopausal hormone replacement therapy and reduction of all-cause mortality and cardiovascular disease: It is about time and timing. Cancer Journal (Sudbury, Mass.), 2022; 28(3): 208–223.
JOHANSSON T, et al. Contemporary menopausal hormone therapy and risk of cardiovascular disease: Swedish nationwide register-based emulated target trial. BMJ (Clinical Research Ed.), 2024; (387): e078784.
KALENGA CZ, et al. The association between route of post-menopausal estrogen administration and blood pressure and arterial stiffness in community-dwelling women. Frontiers in Cardiovascular Medicine, 2022; 9: 913609.
KARIM R, et al. Effect of menopausal hormone therapy on arterial wall echo morphology: Results from the Early versus Late Intervention Trial with Estradiol (ELITE). Maturitas, 2022; 162: 15–22.
KIM J, et al. Oral postmenopausal hormone therapy and genetic risk on venous thromboembolism: gene-hormone interaction results from a large prospective cohort study. Menopause (New York, N.Y.), 2022; 29(3): 293–303.
KIM JE, et al. A systematic review and meta-analysis of effects of menopausal hormone therapy on cardiovascular diseases. Scientific Reports, 2020; 10(1): 20631.
LEITE G, et al. Duodenal microbiome changes in postmenopausal women: effects of hormone therapy and implications for cardiovascular risk. Menopause (New York, N.Y.), 2022; 29(3): 264–275.
LI S, et al. Effects of hormone replacement therapy on glucose and lipid metabolism in peri- and postmenopausal women with a history of menstrual disorders. BMC Endocrine Disorders, 2021; 21(1): 121.
PAN M, et al. Update on hormone therapy for the management of postmenopausal women. Bioscience Trends, 2022; 16(1): 46–57.
PRENTICE RL, et al. Randomized trial evaluation of the benefits and risks of menopausal hormone therapy among women 50–59 years of age. American Journal of Epidemiology, 2021; 190(3): 365–375.
RENKE G, et al. Cardio-metabolic health and HRT in menopause: Novel insights in mitochondrial biogenesis and RAAS. Current Cardiology Reviews, 2023; 19(4): e060223213459.
RODRIGUEZ DE MORALES YA, ABRAMSON BL. Cardiovascular and physiological risk factors in women at mid-life and beyond. Canadian Journal of Physiology and Pharmacology, 2024; 102(8): 442–451.
SZABÓ R, et al. Hormone replacement therapy and aging: A potential therapeutic approach for age-related oxidative stress and cardiac remodeling. Oxidative Medicine and Cellular Longevity, 2021; 2021(1): 8364297.
WELLER SC, et al. Hormone exposure and venous thromboembolism in commercially insured women aged 50 to 64 years. Research and Practice in Thrombosis and Haemostasis, 2023; 7(3): 100135.
YOON BK, et al. Effects of menopausal hormone therapy on ambulatory blood pressure and arterial stiffness in postmenopausal Korean women with grade 1 hypertension: a randomized, placebo-controlled trial. Clinical Hypertension, 2021; 27(1): 18.