Female Hormone Replacement (FHR) is a clinical strategy involving the therapeutic administration of exogenous hormones, primarily estrogens and progestogens, to alleviate symptoms and mitigate long-term health risks associated with natural or surgical menopause. The treatment aims to restore circulating hormone levels to a more youthful or premenopausal physiological state, addressing issues like vasomotor symptoms, urogenital atrophy, and bone density loss. A personalized approach is essential, considering the patient’s individual risk profile and specific hormonal needs.
Origin
The concept originated in the mid-20th century as a means to manage the significant discomfort and health sequelae of menopause, initially focusing solely on estrogen replacement. Following extensive clinical trials and risk assessment updates, the therapy evolved to often include a progestogen to protect the uterine lining in women with an intact uterus, leading to the broader term “Hormone Replacement Therapy” (HRT) or the more specific FHR. The therapeutic paradigm is deeply rooted in reproductive and clinical endocrinology.
Mechanism
The mechanism involves the exogenous hormones binding to and activating the estrogen and progesterone receptors in target tissues throughout the body. Estrogen primarily exerts its effects by stabilizing the thermoregulatory center in the hypothalamus, improving bone turnover by inhibiting osteoclast activity, and maintaining the integrity of urogenital tissues. Progestogens are typically included to induce endometrial maturation and prevent the risk of endometrial hyperplasia associated with unopposed estrogen exposure. This targeted receptor activation restores physiological functions diminished by ovarian senescence.
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