The New Science of Hormone Therapy in Mid-Life and Beyond
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Abstract
The use of “natural” or “bioidentical” hormones for women around the age of menopause has become increasingly common over the past decade, but only in the past few years has the science and research begun to catch up and provide evidence-based validation for this approach.
This review begins with an overview of the medical rationale for using hormone therapy (HT), including vitamin D, and how research in the past decade has changed perceptions of when and why HT should be prescribed.
Next, we discuss specific hormones and symptoms, with a focus on how science has informed our view of both the menopausal transition and the use of various hormone therapies. These discussions bring us to a more in-depth discussion of specific hormones and long-term health issues in postmenopausal women such as osteoporosis and cancer.
Finally, we finish with an another in-depth discussion of research on specific approaches to HT, including progestins vs. progesterone, oral vs. transdermal applications, hormone combinations, and the effects of these therapies on both perimenopausal symptoms, and long-term health issues such as heart disease, cancer and sexual health.
Clinicians continue to need results of high quality research in order to make informed recommendations to their patients. Knowledge about physiologic changes occurring in the menopausal transition, and maintaining long-term health, is expanding rapidly. Certainly more research is needed, yet decisions must be made on a daily basis to assist patients, using the best information currently available. It is hoped that this publication will be helpful in making those decisions and recommendations.