HORMONE REPLACEMENT THERAPY IN CLIMACTERIC AND MENOPAUSE: ANALYSIS OF BENEFITS AND RISKS - A SYSTEMATIC REVIEW

Abstract

Objective: This study aims to analyze the scientific production on Hormone Replacement Therapy (HRT) in climacteric and menopausal patients, identifying its main benefits and risks, as well as the best clinical practices associated with this therapeutic intervention. Methodology: A systematic review was carried out to understand the essential aspects of HRT. The research was guided by the question, "What are the main benefits and risks associated with Hormone Replacement Therapy in climacteric and menopause, and what are the recommended clinical practices?" To answer this question, searches were performed in the PubMed Central (PMC) database using the descriptors combined with the Boolean term "AND": (Hormone Replacement Therapy) AND (Menopause) AND (Women's Health) and (Hormone Replacement Therapy) AND (Climacteric). The initial search resulted in 127 articles, of which 60 were excluded because they were duplicates. A total of 67 unique articles were selected, and after applying inclusion and exclusion criteria, 29 articles were analyzed in detail, of which 16 were used to compose the final collection. Results: HRT demonstrates significant efficacy in relieving vasomotor symptoms such as hot flashes and night sweats, as well as in improving the bone, cardiovascular and sexual function of menopausal women. However, HRT is not without risks, including increased incidence of breast, endometrial, and gastric cancers, as well as cardiovascular risks such as venous thromboembolism, stroke, and myocardial infarction. The choice of hormone formulation, dosage, and route of administration are critical factors in minimizing these risks and maximizing benefits. Alternative therapies and lifestyle changes also play an important role in managing menopausal symptoms and may be considered for women who are unwilling or unable to use HRT. Conclusion: HRT offers significant benefits, but it also presents risks that should be carefully evaluated. Personalization of therapy, based on individual needs and risk profiles, is essential to achieve the best results. Ongoing research and individualized clinical practice are key to advancing understanding the benefits and risks associated with HRT, providing high-quality care, and improving women's quality of life during the climacteric and beyond. Effective public health policies, combined with public education and awareness, are essential to maximize the benefits of HRT and protect the health of future generations.