What is the typical first-line treatment for menopausal symptoms?

Hormone replacement therapy (HRT) is recognized as the typical first-line treatment for menopausal symptoms, particularly for moderate to severe symptoms such as hot flashes, night sweats, and vaginal dryness. This approach aims to alleviate the physiological changes that occur during menopause due to decreased estrogen levels. HRT can significantly improve the quality of life for many women by addressing both physical and psychological symptoms associated with menopause.

HRT can include various combinations of estrogen, progesterone, and sometimes testosterone, tailored to the individual's specific health profile and symptomatic needs. For example, women with an intact uterus are often prescribed a combination of estrogen and progesterone to reduce the risk of endometrial cancer associated with unopposed estrogen therapy.

In contrast, while antidepressants can offer relief for some women, particularly those with mood disorders, they are not the primary therapy for menopausal symptoms. Vitamin D supplements play a role in bone health and preventing osteoporosis but do not address the common vasomotor and genitourinary symptoms of menopause. Oral contraceptives can be used in younger women who are perimenopausal, but they are not typically indicated for menopausal symptom management in the broader context of HRT during the menopausal transition. Thus, HRT stands