Hormone therapy (HT) in women with premature ovarian insufficiency or early menopause: Time to think of a new paradigm for healthy aging. A joint FIGO and IMS position paper.

Climacteric : the journal of the International Menopause Society · August 2026 · Chiara Benedetto, Suvarna S Khadilkar, Rossella E Nappi, Andrea R Genazzani, Federica Frezet, et al.

What this study found

Premature ovarian insufficiency (POI) and early menopause (EM) affect millions of women worldwide. Compared with normal menopause, they confer a longer duration of estrogen deficiency and are associated not only with a shorter lifespan, but with a reduced healthspan, owing to an increased risk of cardiovascular, skeletal, cognitive and psychological morbidity, and sexual health concerns.

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Clinical questions this paper informs

Synthesis lives on the evidence question — this page shows where the study sits in that analysis.

Core study

Does hormone replacement therapy reduce cardiovascular risk in early menopause?

The timing hypothesis suggests earlier initiation may differ from late initiation, where WHI showed harm for combined therapy. Current guidelines emphasize individualized risk assessment rather than routine cardioprotection.

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Core study

Should women with early surgical menopause receive hormone therapy?

Women with premature or early surgical menopause should generally receive hormone therapy until the average age of natural menopause unless contraindicated, to mitigate bone, cardiovascular, and symptom burden associated with early estrogen loss.

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Supporting literature

Does hormone replacement therapy increase breast cancer risk?

Combined estrogen-progestin therapy is associated with a small increased breast cancer risk in WHI and observational data. Estrogen-alone in hysterectomized women showed lower risk in WHI, but interpretation depends on regimen, duration, and individual risk factors.

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