New HRT options for the treatment of menopausal symptoms and the maintenance of quality of life in postmenopausal women.

Quality of life (QoL) is an important aspect that reflects the way people feel and function. The assessment of QoL quality of life is an essential tool for estimating the efficacy of any therapy in different pathophysiological conditions. In normal, healthy women, the perception of QoL can be significantly modified during the peri/postmenopausal period. Conventional HRT improves not only symptoms, but also QoL. Selection of patients, as well as the choice of a personalized HRT in terms of doses, types, routes of administration, and combination, are the keys to optimize the benefits and reduce the risks. One type of HRT cannot fit all populations of postmenopausal women. The safety and the benefit/risk ratios reported for the standard higher doses used in the past, as well as in the HERS and WHI trials, cannot vaguely be referred to different preparations, and particularly to newer HRT schedules with lower dosages. The demonstration of efficacy of lower-dose HRT provides important information for the treatment of the postmenopausal syndrome. Lower-dose HRT (as 0.3 mg/d of conjugated estrogens) minimizes the side effects and is likely to improve compliance to the treatment. The choice of lower estrogen doses may at least in part reduce the potential risks of postmenopausal hormone use, while maintaining the benefits of conventional HRT.