Feature Article

Hormone therapy and menopause: a protracted misunderstanding explained

Rod Baber



The most recent publications reassessing the data from trials of menopausal hormone therapy all carry the same message: hormone therapy is the most effective option for managing menopausal symptoms and when it is used in appropriate women it has minimal side effects.

Key Points

  • Experts, including investigators associated with the Women’s Health Initiative (WHI) clinical trial, have reached a general consensus that the original claims of harm in the WHI trial were exaggerated.
  • Menopausal hormone therapy is the most effective treatment for menopausal vasomotor symptoms, and adverse events are rare in the target population (women within 10 years of their last menstrual period or before they reach 60 years of age).
  • In women requiring combined oestrogen and progestogen therapy, the use of a neutral progestogen such as micronised progesterone or dydrogesterone may be associated with lower risks of breast cancer and venous thromboembolism.
  • Each woman’s individual risks and needs should be assessed before initiating therapy.
  • Dose and duration of therapy should be consistent with treatment goals and not governed by arbitrary time limits.

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