Literature review of estradiol/dydrogesterone in perimenopausal and postmenopausal women.

Menopausal hormone therapy (MHT) with 17β-estradiol/dydrogesterone (E/D) or Femoston® at a range of doses has been shown to provide effective relief from climacteric symptoms and prevention of osteoporosis in postmenopausal women. However, less is known about personalizing MHT for women who require lower doses, or those with obesity or overweight. A literature search was conducted using PubMed to evaluate the safety and efficacy of E/D in perimenopausal and postmenopausal women, with a focus on women with high body mass index (BMI). The results confirmed that ultra-low and standard doses of E/D provide effective relief from symptoms of estrogen depletion, high rates of amenorrhea and fracture risk reduction, without any new safety concerns. In women with high BMI, E/D was shown to provide effective symptom relief, with no significant differences in adverse event frequency according to BMI subgroups. Safety data suggested that dydrogesterone may confer advantages in terms of venous thromboembolism and breast cancer risk as compared with other progestogens. The findings of this literature review shed light on options for optimizing MHT treatment and doses for perimenopausal and postmenopausal women. Further research is warranted to confirm findings in women with high BMI.