Hormone Replacement Therapy

The article says HRT aims at bone protection, vascular health, cognitive preservation, and metabolic regulation. The article distinguishes MHT as symptom management and HRT as restoration to physiologic hormone levels. The article rejects oral contraceptives as a substitute for hormone restoration in perimenopausal women unless contraception is needed. Oral micronized progesterone is preferred over cream for most women because of better central nervous system effects. The timing hypothesis states that hormone therapy started early in the menopausal transition provides more protective benefit than therapy started late after damage accumulates. The article argues that the Women's Health Initiative used the wrong population, wrong hormones, and wrong timing for judging bioidentical hormone restoration. The hormone replacement therapy findings are described as consistent with evidence suggesting small effects of long-term combined oestrogen-progestin therapy depending on menopausal status. The article argues that ideal hormone replacement should mimic cyclic rhythm rather than only produce static average hormone levels. The article says transdermal creams, injections, patches, and ora…