Menopause is a general term that refers to the cessation of ovarian function, the entire transition from a reproductively active reproductive period to a non-reproductive state of old age, marked by the beginning of irregular menstruation. The symptoms of premenopause and early menopause include: menstrual changes; dysfunction of the vegetative nervous system: hot flashes, sweating, dizziness, headache, numbness in the fingers, abnormal sensations, insomnia, etc.; mental symptoms and emotional changes; changes in the cardiovascular system: susceptibility to hypertension, precordial discomfort, palpitations, shortness of breath. Mid to late menopause: atrophic cystitis manifests as urgent urination, urinary incontinence and frequency, often accompanied by recurrent urinary tract infections. Atrophic vaginitis (dryness, burning, scratching), vulvovaginal dryness, difficulty with sexual intercourse, etc. Late menopause: epidermal thinning, dryness, increased melanin to form age spots; osteoporosis is an important problem that is ignored by everyone. The rate of bone mineral loss in postmenopausal women is significantly accelerated, especially within 3-7 years after menopause, which can easily lead to fractures caused by osteoporosis. Women with menopausal symptoms —- How to treat Menopausal health care interventions include: healthy lifestyle, balanced diet, calcium and vitamin D supplementation, more sun exposure, appropriate exercise, avoiding trauma, regular physical examination, good breast monitoring; active treatment of various comorbidities: hypertension, diabetes, etc., cultivating a wide range of interests, and maintaining a peaceful state of mind. Treatment of menopausal symptoms is divided into: psychological treatment, herbal and phytomedical treatment and hormonal treatment. Chinese herbs and phytomedicines are more effective and safe to use for menopausal symptoms, but they are not as effective as sex hormone therapy for patients with severe menopausal symptoms. Hormone Therapy (HT) refers to the administration of appropriate amounts of estrogen and progestin to pre- and post-menopausal women to relieve the symptoms of abnormal vasodilation and genitourinary tract atrophy caused by estrogen deficiency. Hormone therapy has a history of more than 60 years. After extensive case-control and epidemiological studies, it has been proven that HT can effectively relieve menopausal symptoms such as hot flashes, prevent and treat genitourinary tract atrophy, and reduce the incidence of osteoporotic fractures. Hormone therapy and cardiovascular system diseases A large number of previous epidemiological and cohort and case-control studies have concluded that HT as primary prevention of coronary heart disease significantly reduces the incidence of coronary heart disease in postmenopausal women, but a 2002 US study by WHI showed that hormones do not prevent coronary heart disease in older healthy people. a 1998 US study showed that HT compared with placebo failed to reduce the risk of reoccurrence in women who have already had a myocardial infarction, so HT is not advocated for secondary prevention of coronary heart disease. However, HT does relieve palpitations, chest tightness, chest pain and unstable blood pressure in perimenopausal women and improves the quality of life of patients. The risk of breast cancer, vascular thrombotic disease and other diseases in early menopausal women is less than that of late menopausal women, so the earlier it is used, the greater the benefit and the less the risk of sex hormone therapy. The International Menopause Society has proposed a “window” for HT of less than 60 years of age and less than 10 years of menopause. For older women who have been menopausal for more than 10 years and are over 60 years of age, starting HT again will not achieve a reduction in the risk of cardiovascular disease in postmenopausal women. Hormone therapy for tumors Currently, less than 2% of the population in major cities in China receives HT and uses it for a long time, while the rate of women using HT in the United States, Europe and even Taiwan is more than 35%. The main reason is that domestic physicians and patients have concerns about the side effects of HT, especially the fear of tumors. Tumors related to female hormones include endometrial cancer and breast cancer, and regulated HT does not increase the risk of endometrial cancer compared to postmenopausal women who do not use HT. Breast tenderness occurs in some women with HT and is associated with both estrogen and progesterone. The dose of estrogen can be reduced except for organic lesions of the breast. The WHI study showed that in postmenopausal women with hysterectomy, 7 years of estrogen alone did not increase the risk of breast cancer. Therefore, the International Menopause Society states that the relationship between HT and breast cancer remains controversial, but what is certain is that the possible risk of breast cancer from hormone therapy is small (less than 0.1%/year), and that even if breast cancer does develop, the tumor is well differentiated and does not increase mortality of the disease. Therefore, for the majority of postmenopausal women, it is important to have a mammogram before using HT, and to have regular annual breast examinations to detect abnormal breast lesions early. Does hormone therapy increase weight About 60% of women experience weight gain during menopause. Studies show that weight gain occurs during menstrual disorders in menopausal women, with an average of 2 kg per year, and that fatty tissue is redistributed in a centripetal pattern in the body. Due to the imbalance of hormones, the metabolic level in the body decreases and adipose tissue is not easily consumed, and many women often have a feeling of extreme hunger during this period, making it difficult to resist the temptation of food, so during this stage, it is more suitable for a low-sugar, low-fat diet recipe, while moderate physical exercise can prevent excessive weight gain. And a large number of studies have shown that women treated with sex hormones did not gain weight compared to the control group without medication. Dosing of hormone therapy There is a wide variety of estrogen and progestin preparations on the market, with oral administration being the most common form of dosing, with rapid absorption and a first-pass effect in the liver. The advantages of transdermal use are that the drug is slowly absorbed through the skin, does not increase the burden on the liver, and has no adverse effects on coagulation, especially for patients with impaired liver function but who need estrogen. For elderly women who have developed recurrent urinary tract infections and senile vaginitis with significant urinary urgency, frequency and burning vaginal pain, topical estrogen used vaginally should be the mainstay, which is safe, has minimal systemic effects and can be used for a long time. Hormone therapy – how to monitor safety Before using the medication, doctors need to conduct a comprehensive examination of the patient, including questioning of past medical history, breast palpation, molybdenum palladium or ultrasound examination, pelvic ultrasound to examine the reproductive system, endometrial thickness, cervical cancer prevention smear, blood hormone measurement (E2, FSH), and bone density measurement. During the medication period, if there is no special discomfort, annual safety check can be performed and if there is no abnormality, long-term use is allowed. In conclusion, every woman has to go through menopause, and the advantages of standardized HT outweigh the disadvantages. Special attention should be paid to women during this period so that they can go through this special period smoothly and healthily.