Menopausal HRT

Menopausal Hormone Replacement Therapy (HRT) replenishes declining levels of estrogen and progesterone that occur during the menopausal transition. From a healthspan perspective, this mitigates the systemic consequences of hormone loss, which include accelerated bone density decline (osteoporosis), unfavorable shifts in cardiovascular risk factors, metabolic dysregulation, and potential impacts on cognitive function. By addressing this fundamental endocrine shift, HRT aims to preserve physiological function and reduce the risk of age-related diseases in women.

Verdict

A foundational intervention for post-menopausal women, with careful medical guidance.

Protocol

• Transdermal estradiol (e.g., 0.025-0.1 mg/day) is often preferred to bypass first-pass liver metabolism.
• Micronized progesterone (e.g., 100-200 mg) is co-administered to protect the uterine lining.
• Therapy is typically initiated during perimenopause or early menopause for maximum benefit.

Flags

• Requires a prescription and ongoing monitoring by a qualified physician.
• Risk profile is highly dependent on timing of initiation (early vs. late menopause).
• Oral estrogen increases clotting risk; transdermal application is generally preferred for healthspan.
• Unopposed estrogen (without progesterone) increases uterine cancer risk in women with a uterus.
• Contraindicated for individuals with a history of certain cancers (e.g., breast, uterine).