Over the past decade, there have been many concerns about MenopausalHormone Therapy (MHT). Emerging evidence has challenged previously accepted clinical guidelines, particularly with regard to dosing safety and disease prevention. The previous guidelines caused many menopausal women to miss out on hormone replacement therapy. Guidelines with revised details have been published and are regularly updated by the major local menopause societies. The initial confusion for everyone stemmed from the fact that there were some significant differences in the various published guidelines, which gradually expanded. In the most recent version of the guidelines, these discrepancies are significantly reduced. In response to these differences, the International Menopause Society initiated and organized a roundtable discussion among representatives of the major regional menopause societies in November 2012 to reach consensus on core recommendations for MHT treatment. The purpose of the discussion was to develop a short statement of consensus on the core recommendations for hormone replacement therapy. It is recognized that these core recommendations are not a substitute for the more detailed and generally referenced guideline recommendations developed by each national association, given the global differences in disease and legal constraints. The goal of this document is to highlight the international consensus on MHT treatment and to provide assistance to women’s health and management practitioners in the appropriate use of MHT treatment. 1. MHT is the most effective treatment for vasodilatory symptoms associated with menopause at any age (e.g., hot flashes, excessive sweating, etc.), and the benefits of using MHT far outweigh the risks for women younger than 60 years of age and for women who have had the symptoms within 10 years of menopause. 2, MHT is reasonably effective in preventing fractures in women younger than 60 years of age or within 10 years of menopause who are at risk for osteoporotic fractures. 3. Evidence from clinical randomized trials, observational data, and meta-analyses shows that standard-dose monoestrogen MHT therapy reduces the incidence of coronary heart disease and all-cause mortality in women younger than 60 years of age or within 10 years of menopause. Data from trials of estrogen plus progestin MHT therapy in this population showed a similar trend toward lower all-cause mortality as single-estrogen MHT therapy, but it was not found to significantly reduce or elevate the incidence of coronary heart disease in most randomized clinical trials. 4. Topical low-dose estrogen application is more appropriate for women who have only vaginal dryness or associated painful intercourse symptoms. 5. Treatment with estrogen alone is indicated for those patients who have undergone hysterectomy, and if the uterus is preserved, treatment with estrogen in addition to progestin is indicated. 6. The choice of MHT treatment depends on the individual, taking into account the improvement of quality of life, the principle of health priorities and the patient’s risk factors such as age, time since menopause and the risk of venous embolism, stroke, ischemic heart disease and breast cancer. 7. The risk of venous embolism and ischemic heart disease increases with higher doses of oral MHT, but the absolute risk remains rare in patients under 60 years of age. Observational studies have shown that the risk of MHT treatment is lower with transdermal modes of administration. 8. The risk of breast cancer associated with MHT treatment is a complex issue in women over 50 years of age. The increased risk of breast cancer is primarily associated with the addition of progestin to estrogen and with the duration of dosing. the risk of breast cancer from MHT is small and decreases with treatment cessation. 9. The dose and timing of MHT treatment should be consistent with treatment goals and safety issues, so individualized treatment should be taken. 10, In women with premature ovarian failure, systemic MHT administration is recommended and continues at least until normal menopausal age. 11, The use of artificial compounded bioidentical hormone therapy is not recommended. 12.Current safety data do not support the use of MHT in patients cured of breast cancer.