Hormone Therapy for Menopause Remains Underutilized Despite Benefits, Experts Say
BUENOS AIRES – Despite decades of research demonstrating its efficacy and evolving safety profiles, hormone therapy (MHT) for menopause remains substantially underutilized, even among women who could benefit most, leading experts revealed this week. while acknowledging ancient concerns and contraindications, specialists are emphasizing a shift towards personalized approaches and newer administration methods that mitigate risks and improve outcomes.
The reluctance to embrace MHT stems from lingering fears following early 2000s studies linking hormone therapy to increased risks of breast cancer and heart disease. However,subsequent research has clarified that these risks are often associated with specific types of hormone therapy,dosages,and patient profiles. “There’s been a lot of misinformation,” explains Dr. Ricardo Genazzani, a specialist in climacteric. “I have 90-year-old patients who continue using it.”
A key factor driving renewed interest is the availability of transdermal hormone administration – gels and patches – which bypass the liver, reducing metabolic impact.”The oral versus transdermal route of administration should be evaluated in each particular case,” Dr. Genazzani stated. “In patients with overweight,obesity,disorders such as insulin resistance,diabetes,some cardiovascular risk,we choose the transdermal route due to the lower metabolic impact.” The addition of natural micronized progesterone is also recommended for women who retain their uterus.
Though, MHT is not universally suitable. Specialists emphasize that women with a history of hormone-dependent tumors (breast, endometrial, or ovarian cancer), thromboembolism, migraines with aura, or severe liver disease should not receive MHT. For these patients, localized estrogen treatments like creams or suppositories can address genitourinary syndrome of menopause.
Beyond hormone replacement, experts stress the importance of holistic health. “Estrogens and progesterone help, but the woman also has to help herself,” says Dr. Genazzani, advocating for maintaining a healthy weight, regular exercise, a balanced diet, and sufficient sleep. Dr. Carolina Caro summarizes the approach: “Like any good health program, hormone therapy must be accompanied by healthy habits,” including physical activity, proper nutrition, cessation of toxic habits, proper sleep and weight, as well as stress management.
