The American College of Endocrinology has released a scientific statement highlighting that menopausal hormone therapy is likely to do more good than harm for some women, especially those who have just entered menopause. As a result, HT, which is in the doldrums, may drop back to life. The lead author of the scientific statement, Santen of the University of Virginia, noted that HT was popular in the 1990s out of a desire to ease menopausal symptoms and reduce the risk of cardiovascular disease, fractures and dementia, but the Women’s Health Study WHI showed that HT was instead associated with an increased risk of heart disease, stroke and breast cancer, another rapid cooling of HT. Recent studies suggest that these risks may be related to the time between entering menopause and starting HT. Compared to those who started HT after age 60, those who started HT at age 50-59 had a significantly increased benefit. 5 years of HT intervention resulted in a 30-40% reduction in the risk of death and a 90% reduction in menopausal symptoms such as facial flushing and overactive bladder, without an increased risk of cardiovascular disease, although there was still an increased risk of breast cancer, but only in those on combined E/P therapy. In contrast, the average age of those enrolled in the WHI study was 63 years, with only 3.5% of those just entering menopause (50-54 years), who were the primary population considered for HT. In addition, the WHI study was not designed to consider the efficacy of HT on menopausal symptoms. For this reason, the scientific statement incorporates new data focusing on the effects of HT in women aged 50-55 years and draws the following conclusions with Level A evidence: estrogen alone or in combination with progestin is effective in reducing the frequency and severity of facial flushing, and some women are effective with low doses of estrogen; postmenopausal use to prevent postmenopausal bone loss and increase bone mass is comparable to bisphosphonate therapy; may Decreased risk of hip and vertebral fractures; X-rays show increased breast density in users; although long-term combined estrogen and progestin does not cause endometrial cancer, estrogen alone increases that risk; increased risk of gallbladder disease. Tibolone, may be a treatment option for postmenopausal vasoconstriction symptoms; may improve genitourinary tract atrophy; may significantly reduce the risk of vertebral and nonvertebral fractures in women over 60 years of age with osteoporosis; may increase the risk of breast cancer recurrence; may increase the risk of stroke when used in older women; does not increase the risk of endometrial hyperplasia or endometrial cancer. Raloxifene: May significantly increase bone mineral density and reduce the risk of vertebral fracture, but not hip fracture; may reduce the risk of breast cancer; may increase the risk of venous thrombosis; does not increase the risk of stroke. Other: E/P combination therapy may reduce the risk of colon cancer; intravaginal use of very small doses of E2 may be effective in relieving symptoms of vaginal atrophy; intravaginal use of E may reduce the risk of urinary tract infections; transdermal administration of physiologic doses of testosterone improves sexual function, while dehydroepiandrosterone is ineffective; women receiving HT have an approximately 1-fold increased risk of venous thrombosis, and this risk is increased if accompanied by age, high BMI, propensity to thrombosis, surgery and This risk is multiplied by risk factors such as braking; hormone use does not reduce stroke risk in older women with existing vascular disease; and starting HT after age 60 does not improve memory. Santen emphasized that women aged 50-55 years are the primary population considered for HT, that HT may have multiple benefits for this population, and that clinicians should use the evidence for this population as the primary basis for clinical decision making and individualize treatment strategies based on patient-specific symptoms and potential risk.