Sex hormone therapy and progression of cardiovascular disease in menopausal women

Menopausal hormone treatments (MHT) relieve symptoms of menopause. However, their long-term effects on reducing chronic conditions of aging, in particular, cardiovascular (CV) disease, are controversial. With the changes in clinical practice towards lower doses and differing formulations of these products, future investigations into CV consequences of these treatments will be challenging. The current approach to individualizing MHT considers the severity of the menopausal symptoms, a personalized risk assessment, and the patient's personal preferences [1]. Further study is needed to determine whether accounting for genetic variants of oestrogen metabolism and the influence of genetic variants contributing to complex traits, such as those defining CV disease, with the hormone treatment (pharmacogenomics of hormones) will assist in personalizing treatment and benefit CV health. In order for a precise, personalized approach to maximize benefit and reduce risk of menopausal hormones to become a reality, algorithms will need to include genotype in conjunction with the treatment goal (symptom relief), consideration of other medications and environmental factors.