Guidance on Hot Topics in Menopause Hormone Replacement Therapy

  The use of hormone supplementation during menopause has always been controversial, and related studies have never been interrupted. However, studies in the past 10 years have once again reached a consensus: As a medical measure, hormone supplementation therapy during menopause must follow treatment norms, should be strictly controlled in terms of indications and contraindications, and should be promoted in appropriate populations to avoid abuse; at the same time, hormone supplementation therapy should be started as early as possible in menopause, which will bring long-term protective effects on the skeletal, cardiovascular and neurological systems and enable women of appropriate age to This will bring long-term protective effects on the skeletal, cardiovascular and neurological systems and maximize the benefits for women of appropriate age with low risk.  Indications for menopausal hormone supplementation: (1) Menopause-related symptoms: menstrual disorders, hot flashes, excessive sweating, sleep disturbances, fatigue, mood disorders such as agitation, irritability, anxiety, nervousness, or depression.  (2) Have symptoms related to genitourinary tract atrophy: such as vaginal dryness, pain, painful intercourse, recurrent vaginitis, difficulty urinating, recurrent urinary tract infections, nocturia, frequent and urgent urination.  (3) Having low bone mass and osteoporosis: including having risk factors for osteoporosis and postmenopausal osteoporosis.  Contraindications to menopausal hormone supplementation therapy: known or suspected pregnancy; unexplained vaginal bleeding; known or suspected breast cancer; known or suspected endometrial cancer; active venous or arterial thromboembolic disease (within the last 6 months); severe hepatic or renal dysfunction; hematoporphyria, otosclerosis; known meningioma (progestins are contraindicated).  Cautionary conditions for menopausal hormone supplementation therapy: Cautionary conditions are not contraindications, and it is possible to apply menopausal hormone supplementation therapy, but before and during the application process, the appropriate professional physician should be consulted to jointly determine the timing and manner of applying HRT, while adopting closer monitoring than routine follow-up. Cautionary conditions include uterine fibroids, endometriosis, history of endometrial hyperplasia, uncontrolled diabetes and severe hypertension, tendency to thrombosis, gallbladder disease, epilepsy, migraine, asthma, hyperprolactinemia, systemic lupus erythematosus, benign breast disease, and family history of breast cancer.