Which pathway addresses menopause?
Postmenopausal symptoms route to BHRT when the benefit-risk profile favors initiation. Timing relative to menopause onset, cardiovascular health, and personal/family breast and thrombotic history shape the decision.
Full answer
Menopause is defined by 12 months of amenorrhea. Symptoms span vasomotor, sleep, mood, cognition, libido, weight, bone, and genitourinary domains. BHRT addresses symptomatic menopause; the strength of recommendation depends on time since menopause onset (the 'window of opportunity'), cardiovascular health, and personal/family breast and thrombotic history. Local vaginal estradiol is appropriate for isolated genitourinary symptoms with a different systemic risk profile. Every plan is synchronous-video reviewed.
Educational. Not a substitute for individualized provider review.
- BHRT Optimization pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03