Navigating menopausal hormone therapy as CVD risk grows

The use of menopausal hormone therapy for treatment of bothersome hot flashes in women is complex, with conflicting studies causing confusion about risks and benefits. Many clinicians are reluctant to prescribe hormone therapy due to uncertainty around evidence-based guidelines, despite recent data suggesting it may be safe and appropriate for most women at low cardiovascular disease risk. A more nuanced approach is recommended for women at intermediate cardiovascular disease risk, with options including systemic hormones, transdermal estrogen and progesterone, and vaginal estrogen. Non-FDA approved compounded bioidentical hormones are not recommended. It is important for clinicians and patients to understand the new information and guidance regarding hormone therapy.

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