AACE MENA 2025-Menopause Hormone Therapy 101

Video Transcription

Video Summary

The speaker discusses menopause and hormone therapy from an internist’s perspective. Menopause is defined as 12 months without menstruation, typically occurring around age 52 in the U.S., but varies globally. Perimenopause—the symptom phase leading up to menopause—can last 6-10 years. Common symptoms include hot flashes, joint pain, sleep disruption, mood changes, vaginal dryness, and brain fog, with about 80% of women experiencing hot flashes lasting seven to nine years on average. Hormone therapy (HT) is underutilized in the U.S., with only 1.7% of women receiving systemic HT, despite its proven efficacy for moderate to severe symptoms, premature menopause, and osteoporosis prevention. Timing matters: HT is safest and most effective when started within 10 years of menopause or before age 60. Transdermal estrogen is preferred for women with cardiovascular risk. Compounded bioidentical hormones lack standardization and safety data compared to FDA-approved options. There is no defined age or duration cutoff for HT; treatment should be individualized, monitored regularly, and continued as needed.

Keywords

menopause

hormone therapy

perimenopause

hot flashes

transdermal estrogen

bioidentical hormones