Hormone replacement therapy (HRT), either with estrogen or estrogen plus progestin, is considered the most effective treatment option for relief of hot flashes and other menopausal symptoms. 8 However, due to potential HRT-associated health hazards, women should consult with their physicians prior to HRT to determine whether potential benefits outweigh risks. Currently, the North American Menopause Society and the American College of Obstetricians and Gynecologists recommend using the lowest effective dose and for the shortest duration possible. Women over 60 years old who experienced natural menopause at a typical age and never used HRT are discouraged from doing so without compelling reasons. 4 Women with a history of cardiovascular events, venous thromboembolism, breast or uterine cancer, or liver disease should not use estrogen to alleviate vasomotor symptoms. 1

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