Menopause, Hormonal Therapy, and Long-Term Women’s Health

This chapter provides a critical appraisal of the evolving evidence on menopausal hormone therapy (MHT), revisiting the re-analysis of landmark trials and reviewing contemporary data on the risks and benefits of estrogen-based, progestogen-containing, and bioidentical formulations across different patient populations and routes of administration. It examines advances in the management of genitourinary syndrome of menopause (GSM), vasomotor symptoms, and bone health, including the emerging role of non-hormonal pharmacologic options and tissue-selective estrogen complex therapies. The chapter also addresses the interface between menopause and cardiovascular health, cognition, and quality of life, offering guidance on individualized risk-benefit counseling.