At the end of the 20th century, with the increase of human life expectancy, it has been gradually found that in addition to menopausal syndrome and genitourinary tract atrophy, osteoporosis and fracture, cardiovascular diseases and dementia are also increasing in women after menopause, which affects the quality of life of individuals and brings great pressure and burden to the society and family. Hormone replacement therapy (HRT), which started in the 1960s, has played an important role in alleviating menopausal syndrome and reducing osteoporosis and fractures, improving women’s quality of life, and reducing the stress and burden on society and families. In 2002 the WHI study [1] (Women’s Health Initiative) announced the discontinuation of a group of HRT (0.625 mg of combined estrogen plus 2.5 mg of amnestic progesterone daily) because they found that after 5.2 years of application of the above prescription, compared to placebo, there was a 41% increase in stroke, 29% increase in heart attack , a doubling of venous thrombosis, a 22% increase in total cardiovascular disease, a 26% increase in breast cancer, a one-third reduction in hip fractures, a 24% reduction in total fractures, and a 37% reduction in the incidence of colorectal cancer, with no difference in overall mortality. This was a large, multicenter, randomized controlled clinical trial conducted in the United States with the primary objective of evaluating the benefit/risk ratio of long-term HRT in postmenopausal women. When this report came out, it quickly caused a storm around the world, with both medical professionals and the general public showing great concern and worry about HRT. We believe that the WHI was entirely correct to discontinue this prescription, which showed an unfavorable increase in cardiovascular disease with breast cancer at 5.2 years, but also limited to the continuous use of 0.625 mg of combined estrogen plus 2.5 mg of amnestic progesterone daily, and in women who were older, fatter, and had similar characteristics to the included subjects. In other cases it may still be useful, much less can it be easily extended to the whole issue of the pros and cons of HRT for postmenopausal women, and thus deny the good effect played by decades of hormone replacement therapy for postmenopausal women.The issues raised by WHI are also new questions and challenges for medical practitioners in the process of scientific development, and require us medical practitioners to think about them and combine them with the disease characteristics of Chinese women and We need to think about new ways and methods to solve the problems, taking into account the characteristics of Chinese women’s diseases and clinical treatment experience. The recent, mid-term and long-term complications after menopause can be divided into five major categories: menopausal syndrome, genitourinary tract atrophy, osteoporosis, cardiovascular disease and Alzheimer’s disease, which are more complex than the other. At the same time, with increasing age, patients may combine or develop some new problems of organ degeneration. It is a test for clinical workers to find clues and solve problems from the complex and mixed states. Menopausal syndrome appears around the time of menopause and is the main and common reason for menopausal women to seek treatment, including vasodilation-specific symptoms such as hot flashes and excessive sweating, others may be accompanied by depression, irritability, fatigue, sleep disturbances, etc. Sometimes the symptoms are mild and do not require medication, and sometimes they are severe and require larger doses of medication to help relieve and control the symptoms. As far as the symptoms themselves are concerned, the duration varies and is difficult to predict, but regardless of the severity or length, they will disappear after a period of time and rarely recur. Estrogen has a specific, and sometimes irreplaceable, role in relieving menopausal syndrome. The ability to improve the patient’s symptoms is an important factor affecting the quality of life, so the application of HRT under strict control of indications and contraindications is still very valuable. The standardized therapy should be adhered to, and the application of HRT should be individualized, including the dose, dosage form and compounding scheme, etc. The principle of the lowest effective dose should be adopted to find the best effective medication method for each patient, and constant adjustments should be made according to the effect of use, duration and the specific conditions of individuals, and regular follow-up monitoring should be carried out. However, HRT is not a panacea for the syndromes appearing in menopause, and not all of them are effective for some new non-specific problems appearing in menopause, such as dry eyes, dry mouth and tinnitus, etc. After the examination and treatment of ophthalmology and quintuplegia except for organic lesions, a short-term trial of a larger dose of HRT can be conducted, and if the effect of HRT is not good, the valuable and abundant Chinese medicine resources in China should be given full play to comprehensive treatment, and most of them can achieve good Most of them can achieve good results. For patients with heavy symptoms of depression, irritability, anxiety and sleep disorders, they should collaborate with neurologists and psychiatrists to obtain satisfactory results through HRT synergistic antidepressant, anti-anxiety and sedative treatment. In addition, menstrual disorders during menopause are also a common reason for perimenopausal women to visit the clinic, usually manifesting as prolonged or shortened menstrual cycles, prolonged or shortened duration, vaginal bleeding, and in severe cases, severe anemia. In these patients, the first step is to ask questions about the accompanying symptoms, to understand and determine whether the changes are related to hormonal changes during menopause, to exclude possible organic changes, and to provide symptomatic management. For those with dripping vaginal bleeding, a simple approach is to use regular progestin withdrawal to smooth the transition to menopause in perimenopausal women. If treatment is not effective, care should be taken to exclude other endocrine disorders and organic gynecological lesions. Genitourinary tract atrophy worsens with age and is often prone to atrophic inflammation, such as vaginal dryness, painful intercourse, itching, low or increased leucorrhea with odor, recurrent lower urinary tract infections, urethritis and urinary incontinence, etc. Estrogen supplementation is needed to make the genitourinary tract epithelium healthy and resistant to inflammation. At present, small doses of estrogen are sufficient for intermittent topical or systemic use; or topical use of estriol preparations alone, as the dose is small and systemic absorption is also low, and the risk of endometrial and breast cancer is low, but the symptoms are likely to recur after stopping the drug. For patients who cannot or do not want to use estrogen, symptoms can be relieved by intermittent vaginal topical application of methotrexate effervescent tablets. Osteoporosis worsens with age. It is estimated that about 20% of Asian women over the age of 50 suffer from osteoporosis and 52% have reduced bone mass. In China, osteoporosis or low bone density is present in about 55% of women over 50 years of age. Fractures can occur in 50% of women due to osteoporosis, and respiratory and cardiovascular diseases (such as pneumonia or blood clots) caused by bed rest after a fracture can be life-threatening. According to statistics, the mortality rate due to osteoporotic fractures in women exceeds that of breast cancer, cervical cancer and endometrial cancer combined. Bone mass increases gradually from the fetus onward, reaching a peak around the age of 35. Thereafter, bone mass is lost with age until the end of life. After menopause, women lacking estrogen and androgens lose bone mass faster and more than men, making them more susceptible to osteoporosis and fractures, bone and joint pain, hunchback, and shortening. Bone loss leads to deformity after trabecular fracture, which cannot be saved, but is completely preventable. Therefore, prevention of bone loss after menopause is one of the important preventive measures against osteoporosis after menopause, especially for those women with risk factors for osteoporosis, including family history of osteoporosis, insufficient calcium intake, vegetarian diet, lack of physical activity, heavy smoking, alcoholism, advanced age, and early menopause (4 years), there is no need for excessive warnings. The risk of individual women using HRT is minimal, e.g. breast cancer patients with HRT for more than 4 years have an increased risk per year