Hormone replacement therapy, which we see differently today

For a long time, it was self-evident for medical science: if estrogen production ceases after menopause, we simply replace it and can thus restore the protection of the female body. The line of reasoning was logical: when young, estrogen acts as a true shield – reducing the risk of cardiovascular disease, stroke, heart attack, and osteoporosis. However, this advantage disappears with the end of the reproductive life stage, and with the loss of hormones, women's risk levels effectively "catch up" to those of men.

That is why, in the 1990s, more and more women worldwide received hormone replacement therapy, often routinely – accompanied by enthusiasm, high hopes, and strong preventative goals. But the enthusiasm did not last long. In the early 2000s, a major clinical study was published that fundamentally shook the previous theory. It turned out that hormone replacement therapy is not safe for every woman; in fact, if started after a certain age, it can increase the risk of stroke or thrombosis.

This realization shocked the profession – and made hormone replacement therapy a taboo for a long time. In Hungary, this is still felt today: many doctors rely on knowledge from two decades ago, and patients are often distrustful, even dismissive of the therapy. Yet this is a serious misunderstanding. Since then, science has re-evaluated the data and painted a much more nuanced picture.

We now know that if hormone replacement therapy is started in time, at the onset of menopause, and applied in a personalized way, it can be a safe and effective method – not just for alleviating symptoms, but also for preserving long-term female quality of life. Furthermore, pharmaceutical science has also evolved significantly; instead of the old, synthetic high-dose hormones, we currently use more natural, often locally acting, low-dose agents with negligible risks.