Hormone Replacement Therapy

Matthew Allison & JoAnn Manson

During the menopausal transition, there is a natural diminution of the sex hormones estrogen and progesterone. Hormone replacement therapy (HRT), or hormone therapy (HT), is a medical treatment for symptoms related to the menopause and the menopausal transition. Clinically, HT has also been administered to protect against disorders such as osteoporosis and atherosclerotic cardiovascular disease (CVD). However, recent studies have cast doubt on the protective effect of HT and have identified risks involved with its use. Menopause is the permanent cessation of menstruation due to the loss of ovarian follicular function. The perimenopause refers to the time period immediately preceding menopause when fertility wanes and menstrual cycle irregularity increases. This period continues until 12 months after cessation of menses, at which time the woman is considered menopausal. The mean duration of the perimenopause is 4 years, while signs consistent with the perimenopause may precede the final menses by 2 There ...

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