Recent discussions, such as those in the 2022 Hormone Therapy Position Statement of The North American Menopause Society, suggest that the perceived risks of hormone replacement therapy have been overstated, leading to a reevaluation of current practices and signaling a possible HRT guidelines revision that could broaden its therapeutic reach. As noted in the earlier report, a revision in FDA warning labels could expand hormone replacement therapy’s role in menopause treatment, offering new relief options and improved quality of life for postmenopausal women.
Beyond symptomatic relief in menopause, evolving insights into metabolic pathways are reshaping how clinicians view hormonal interventions in oncology, which differ significantly from hormone replacement therapies. Research on metabolic interactions indicates that cancer cells manipulate immune responses via metabolic crosstalk. While these preliminary findings suggest that targeted hormonal therapies might enhance anti-cancer immunity by interrupting these pathways, clinical efficacy has yet to be established.Age-related shifts in hepatic function add another layer of complexity to personalized hormone therapy. Liver changes with aging highlight how increases in cell size and ongoing inflammation can alter how drugs are processed, underscoring the importance of closely monitoring hormone replacement therapy in older adults.
Assessing hormonal therapy risks is crucial for advancing patient care. Together, these converging data advocate for a more nuanced application of HRT, where updated FDA warning labels align with current evidence on safety, efficacy and metabolic considerations. Clinicians should remain attentive to emerging guidelines, revisit risk–benefit discussions with patients and consider individualized strategies that reflect both symptom management and broader metabolic health.