Update on hormone therapy in the postmenopausal period. Systematic review of literatura

Authors

  • Rebeca Aquino Vargas Universidad Nacional de Chimborazo, Ecuador
  • Danny Sebastián Brito Arteaga Universidad Nacional de Chimborazo, Ecuador
  • Jhudy Alisson Chimbo Shiguango Universidad Nacional de Chimborazo, Ecuador
  • Mateo Nicolás Melo Torres Universidad Nacional de Chimborazo, Ecuador
  • Pablo Guillermo Alarcón Andrade Universidad Nacional de Chimborazo, Ecuador

Keywords:

Menopause, Postmenopause, Hormone Replacement Therapy, Hormone Therapy

Abstract

Introduction: Menopause is characterized by hot flashes and urogenital changes that affect women's quality of life. Hormone replacement therapy (HRT) has been proposed as a strategy to alleviate these symptoms, although its use declined drastically after the findings of the WHI study (2002) regarding cardiovascular and neoplastic risks. Materials and methods: A systematic review was conducted following the PRISMA guidelines in the PubMed, Web of Science, Redalyc, and Dialnet databases (2021-2026). Systematic reviews, meta-analyses, randomized controlled trials, and cohort studies in Spanish or English with open access were included. The AMSTAR 2 and PEDro scales were applied for methodological assessment, resulting in 13 studies for qualitative synthesis. Results: Hormone replacement therapy (HRT) significantly reduces the frequency of vasomotor symptoms (RR 0.43; 95% CI: 0.33–0.57), improves bone mineral density and reduces vertebral fractures, optimizes the lipid profile (reduced LDL, increased HDL), and decreases the risk of type 2 diabetes mellitus (RR 0.70). However, it is associated with an increased risk of venous thromboembolism (RR 1.86), ischemic stroke (HR 3.49 with estrogens alone), and breast cancer with combination therapy. The transdermal route has a better thrombotic safety profile than the oral route. Early initiation (within 3 years postmenopause) is associated with a 32% reduction in the risk of dementia. Fezolinetant 45 mg/day emerges as an effective non-hormonal alternative for vasomotor symptoms. Discussion: The findings confirm that HRT offers significant benefits but with risks that require individualization, with the transdermal route being the safest in patients at thrombotic risk. Conclusions: HRT offers benefits for the skeletal system, lipid profile, and cognitive function when initiated early, but its use must be individualized according to dose, route of administration, formulation, and each patient's risk profile.

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Published

2026-06-19

How to Cite

Aquino Vargas, R., Brito Arteaga, D. S., Chimbo Shiguango, J. A., Melo Torres, M. N., & Alarcón Andrade, P. G. (2026). Update on hormone therapy in the postmenopausal period. Systematic review of literatura. Maestro Y Sociedad, 23(2), 2229–2239. Retrieved from https://maestroysociedad.uo.edu.cu/index.php/MyS/article/view/7781

Issue

Vol. 23 No. 2 (2026)

Section

Artículos

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Copyright (c) 2026 Rebeca Aquino Vargas, Danny Sebastián Brito Arteaga, Jhudy Alisson Chimbo Shiguango, Mateo Nicolás Melo Torres, Pablo Guillermo Alarcón Andrade

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