Common Misconceptions in Hormone Therapy (HT) Treatment in Menopause

The purpose of this review is to address the misconceptions surrounding Hormone Therapy (HT) in menopause largely surrounding the findings from Women’s Health Initiative (WHI). The review explores the history of HT, the risks and benefits, along with current guidelines for HT and non-hormonal options. A comprehensive search was conducted using electronic databases focusing on the effect of HT on breast cancer, cardiovascular health, bone health, and quality of life. Studies that analyzed the implications from the WHI were included as well as the North American Menopause Society (NAMS) current recommendations and guidelines for treatment options in menopause. Findings from the WHI initially raised concern for an increased risk of certain cancers and thromboembolic risks, however, subsequent analysis of that data and in observational studies support HT as a safe, viable option when initiated within a specific timeframe, individualized care, and with specific routes for transmission. This review highlights the importance of clinical education to mitigate biases and improve delivery of care to this patient population which spends over 40% of their lifetime in this menopausal phase. By dismantling outdated fears, this review aims to provide clinicians with the tools to confidently provide care to this patient population. Shared decision making and accurate information are pivotal for advancing menopausal care and the needs of this large population. Keywords: menopause, hormone therapy, women’s health initiative, cardiovascular risks, breast cancer, osteoporosis, timing hypothesis