ABSTRACT
Menopausal hormone therapy (MHT) has its origin in the effort to alleviate specific symptoms associated with the decline of estrogen production at menopause. In the Study of Woman’s Health Across the Nation, researchers found that vasomotor symptoms consistently loaded on a separate factor from other symptoms across all racial/ethnic groups. All symptoms increase in prevalence from premenopause to early perimenopause, while the percentage reporting hot flushes and night sweats declines noticeably from late perimenopause to postmenopause. This is in contrast to a much smaller decline in symptoms of psychological distress. In the last decade, however, the focus of MHT changed from short-term treatment of symptoms to the preventive health care benefits associated with long-term treatment. In particular, these are the disabilities of osteoporosis and the impact on cognition. However, long-term use was challenged by the clinical trial data of olderage women indicating that hormone therapy (HT) does not protect against cardiovascular disease and that the risk of breast cancer was increased.
