Menopause” refers to the last menstrual period in a woman’s life, which occurs around the age of 50 and is a necessary event in the life course of every long-lived woman. It marks the end of a woman’s reproductive function and the failure of ovarian function. However, in the years before and after menopause, women are brought into the eventful “menopause” due to huge changes in physiological regulation and endocrine metabolic disorders and imbalances. Women in menopause often experience menstrual disorders, hot flashes, sweating, palpitations, fatigue, mood changes, depression and anxiety, loss of interest and reduced work efficiency, which are often referred to as menopausal syndrome. After menopause, due to the extreme lack of female hormones, menopausal-related diseases such as atrophy of the genitourinary tract, difficulties in sexual life, recurrent urinary tract infections, and osteoporosis may occur. These problems seriously affect women’s physical and mental health and quality of life. Not only that, some old age diseases such as osteoarthritis, hypertension, coronary heart disease, diabetes, and tumors also take advantage of this period to lay hidden dangers, which in turn can affect the health and happiness in later life. Epidemiological surveys show that the age of menopause in Chinese women is around 48 years old, and the frequency of menopause-related symptoms is about 60% to 75%. It is important for women to understand menopause correctly, to treat it correctly, and to spend nearly one-third of their life after menopause peacefully in today’s society, which is concerned about the quality of life. Although hormone supplementation has been used for more than half a century to treat the above-mentioned menopause-related problems, the debate over the pros and cons has never ceased. The 2005 guidelines of the International Menopause Society state that treatment with hormones or hormone replacement is part of the overall prevention of disease (e.g., lifestyle, smoking and alcohol cessation, etc.) and is a healthy way to prevent menopause. etc.) and is a health requirement. In particular, it is advocated that the benefits of starting hormone therapy early in menopause are greater. Of course, like any other drug therapy, hormone therapy is undeniably associated with certain adverse effects. As long as it is properly applied, the benefits are high and the risks are low; conversely, if it is not used according to the norms, the risks may be high and the benefits low. How to evaluate the benefits and risks of hormone therapy? Consistent research evidence suggests that (1) the benefits of hormone therapy include improvement of menopausal symptoms and atrophy of the genitourinary tract and prevention of osteoporosis; (2) the proven risks of hormone therapy include increased risk of stroke, thrombosis and embolism; and (3) the risks of hormone therapy that cannot be determined are breast cancer and cardiovascular disease. In fact, the above-mentioned increased risks from hormone therapy are much lower than some of the risks due to poor lifestyle habits, such as the increased risk of lung cancer from smoking, the increased risk of liver cancer from heavy alcohol consumption, and even the increased risk of pancreatic cancer from drinking more than 4 cups of coffee per day. We need to be cautious about the existence of this risk, monitoring should be strengthened, and the indications and contraindications for hormone therapy should be mastered; not all women need hormone therapy, and not all women can use it; scientific and rational application is the safest. It is worth mentioning that there are some misconceptions about the application of hormone supplementation therapy to menopausal women, such as blindly promoting its “eternal youthfulness” effect to mislead people to abuse it; and the danger of abuse brings fear, and it is regarded as a plague, and people are afraid to hear about it. The confusion about hormone therapy is often confusing. This confusion and misunderstanding exists not only among patients, but also among many clinicians, which needs to be sorted out and clarified. First, “abuse” is dangerous. The blind fear of aging has prompted people to look for ways to prolong their lives, so the following statement has emerged: estrogen should be used after the age of 40 to preserve youth. Some women with normal menstruation, even those under 40, suspect they are entering menopause when they notice “signs of aging” such as deepening wrinkles or mood changes, and request estrogen in the hope of To “prevent” menopause. Some drugs or supplements advertise their ability to slow down ovarian aging and delay menopause, but in fact, the number of follicles in the ovaries at birth and the rate of follicle depletion determine the timing of menopause, and current drugs cannot intervene in these factors. The above situation often results in hormone abuse. In fact, hormone therapy is not a panacea for eternal youth. It is not necessary or desirable to apply hormone therapy, and its abuse can increase the risk, which is consistent with the application of other drugs. More often than not, there is a “fear of using”. The reasons for fear of using hormones include: weight gain, dependence on hormones, and tumor development. Do hormones cause weight gain? Estrogen can cause water and sodium retention, but at low doses, the effect is not significant. One study showed that women who applied hormones and placebo both gained weight after 1 year, but the difference between the two groups was not significant. Weight gain has many factors such as genetics, age, and lifestyle, and the effect of hormones should not be considered alone. In life, young women tend to be slim and post-menopausal tend to be fat; in women estrogen levels are much higher than in men, but it is not seen that women are much heavier than men. These can help us to understand the relationship between estrogen and weight gain, and the Practical Guidelines for Postmenopausal Hormone Therapy from the 4th Amsterdam Menopause Conference in October 2004 suggests: “There is substantial evidence that hormone therapy does not cause weight gain.” Does hormone use cause tumors? There are two main types of estrogen-related tumors – endometrial cancer and breast cancer. before the 1970s, estrogen alone was mostly used and tended to increase the risk of endometrial cancer, but after the 1970s, in women with an intact uterus, the addition of progestin counter therapy no longer increased the risk of endometrial cancer. As for breast cancer, since the application of hormone supplementation more than 60 years ago, several studies have failed to fully confirm the association between hormone supplementation and breast cancer. In response to the findings of the Women’s Health Initiative (WHI) study in the United States and the Million Women Study (MWS) in the United Kingdom that hormone therapy increases the risk of breast cancer, the International Menopause Society (IMS) issued statements in 2004 and 2005 stating that the WHI and MWS claims that hormone therapy increases the risk of breast cancer were inconclusive and needed further clarification. Further clarification is still needed; the WHI and MWS have not confirmed that hormone therapy during the menopausal transition leads to an increase in breast cancer, and this issue remains to be resolved. The reason that the International Menopause Society does not consider the findings of the WHI and MWS studies to be definitive is that both studies had significant limitations in their design and enrolled an older population that did not confirm the menopausal transition. Of course, “the relationship between hormone supplementation and breast cancer is not certain” does not mean that hormones can be used casually, but the indications and contraindications should be strictly controlled when applying them, and regular monitoring before and during use should be paid attention to minimize the possible risks. Others say, “Since menopause is a natural physiological process, then the application of hormone therapy is against the natural law.” It is true that menopause is a natural phenomenon and not a disease, but menopause can cause symptoms and diseases associated with it. Hormone therapy is not intended to stop the natural process of menopause, but rather to address the problems associated with the process, i.e., the diseases associated with menopause. This is very similar to human aging. Aging is certainly a natural process, not a disease, but aging can cause aging-related diseases, and the medication administered to the elderly is not intended to stop aging, but to treat aging-related diseases. For hormone therapy, the International Menopause Society in its 2004 statement and 2005 statement amendment stated that (1) clinical use of hormone supplementation continues to be recommended; (2) there is no new reason to impose a limit on the duration of hormone supplementation; (3) there is no overarching guideline for making decisions about whether and whether to continue hormone use in individuals (individualization); (4) the application of hormones or hormone replacement will be one of the most important measures to slow down aging and improve quality of life.