CLINICAL REVIEW Efficacy, Safety, and Tolerability of Low-Dose Hormone Therapy in Managing Menopausal Symptoms

Use of the lowest clinically effective dose of postmenopausal hormone therapy conforms to current rec-ommendations and good clinical practice. Although accumulating evidence demonstrates the efficacy and tolerability of low hormone therapy doses, data about their use are limited by a lack of long-term, randomized studies. This review evaluates current evidence on the efficacy, safety, and tolerability of these preparations and their role in menopausal management. (J Am Board Fam Med 2009;22: 563–573.) The primary indication for postmenopausal hor-mone therapy (HT) is to relieve the vasomotor symptoms (hot flashes, night sweats) and vaginal dryness and discomfort that often accompany the menopausal transition and beyond. These symp-toms, which are attributed to the natural decline in estrogen during and after menopause, can be rem-edied with HT. The loss of bone mineral density (BMD) and associated skeletal fragility and in