Abstract
During the climacteric, many women present different symptoms that affect their quality of life. These symptoms have been related to disorders of the neurochemistry of the central nervous system caused by fluctuations and/or lack of estrogen. Brain chemistry disorders that occur during the climacteric would also be involved in changes in body composition and the increase of adipose tissue. In obesity, the adipocyte produces adipocytokines that lead to a chronic inflammatory state that increases the risk of diabetes, hypertension and hypercoagulability, hence, increasing cardiovascular risk. Estrogen deficiency also modulates cellular signals (RANKL, NPY) that favor bone resorption and the risk of osteoporosis. In addition, obesity increases the risk of breast, endometrial, colon, and gallbladder cancer by increasing leptin and interleukin-6. Also, important to mention is that fact some studies have also suggested an anti-Alzheimer action of ovarian steroids. Menopausal hormone therapy (MHT) continues to be the gold standard for the treatment of vasomotor symptoms, genitourinary syndrome of menopause (GSM), and sleep problems, thus, significantly improving female well-being and quality of life. Due to its metabolic effects, it would play a role in the prevention of bone loss, fractures and other chronic diseases, hence decreasing mortality. Not prescribing MHT to women who need it means depriving them of a potentially beneficial therapy for their health. The aim of this review is to substantiate the reasons why doctors, decide to prescribe MHT to their patients.
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