Menopause Hormone Therapy (MHT) is a targeted medical intervention utilizing exogenous estrogen, often combined with progestogen, to alleviate the systemic symptoms associated with estrogen deficiency during and after the menopausal transition. The therapy is clinically indicated for managing moderate to severe vasomotor symptoms, urogenital atrophy, and preventing accelerated bone density loss. Treatment protocols require individualized risk assessment and precise dosing to achieve symptomatic relief while maintaining patient safety. The goal is to restore a more comfortable state of hormonal equilibrium.
Origin
The practice originated in the 1940s and 1950s with the advent of pharmaceutical estrogen preparations to treat menopausal symptoms. The term has evolved from Hormone Replacement Therapy (HRT) to MHT to emphasize that the therapy is specifically for menopause-related symptoms and to differentiate it from other forms of hormonal treatment. This evolution reflects a refined clinical understanding of appropriate patient selection, treatment window, and therapeutic goals.
Mechanism
MHT functions by introducing exogenous estrogens that bind to estrogen receptors (ERα and ERβ) in various target tissues, including the hypothalamus, bone, and urogenital tract. This binding restores the estrogenic signaling cascade that is diminished during menopause, thereby stabilizing thermoregulatory control and maintaining tissue integrity. The addition of progestogen is necessary in women with an intact uterus to mitigate the risk of endometrial hyperplasia associated with unopposed estrogenic stimulation.
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