The efficacy of menopausal hormone therapy for bothersome menopausal symptoms is well established. However, there are a range of benign and malignant gynaecological conditions that pose a challenge in managing menopausal symptoms. Their hormone-dependent nature either raises concerns about symptom recurrence or malignant disease progression making decisions about menopausal hormone therapy complex for both clinicians and patients. It appears there is a small potential for symptom recurrence with menopausal hormone therapy use in menopausal women with a history of severe endometriosis. Malignant transformation of previous endometriotic lesions is likely to be rare but is not adequately understood. In this setting, combined hormone therapy is preferred, including in woman post-hysterectomy. Uterine fibroids are not a contraindication to menopausal hormone therapy use but women with large fibroids at menopause should have regular follow-up of their fibroids. Generally, menopausal hormone therapy is considered appropriate for women with cervical cancer and most ovarian cancers except for low grade serous tumours. Endometrial cancer requires an individualised discussion. The overall quality of data in this area is poor but suggests women with a low risk of recurrence may consider hormonal therapy, balancing symptom impact with prognosis.

更年期激素疗法对令人烦恼的更年期症状的疗效已得到充分证实。然而，有一系列良性和恶性妇科疾病对管理更年期症状构成挑战。它们依赖激素的性质引起了对症状复发或恶性疾病进展的担忧，从而为临床医生和患者做出关于更年期激素治疗复合物的决定。在有严重子宫内膜异位病史的绝经期妇女中使用绝经期激素治疗似乎有很小的症状复发可能性。先前子宫内膜异位病变的恶性转化可能很少见，但尚未得到充分了解。在这种情况下，首选联合激素治疗，包括女性子宫切除术后。子宫肌瘤不是绝经期激素治疗的禁忌症，但绝经期大肌瘤的女性应定期随访其肌瘤。一般来说，绝经期激素治疗被认为适用于患有宫颈癌和大多数卵巢癌的女性，除了低级别浆液性肿瘤。子宫内膜癌需要个体化讨论。该领域的总体数据质量较差，但表明复发风险低的女性可以考虑激素治疗，以平衡症状影响与预后。子宫内膜癌需要个体化讨论。该领域的总体数据质量较差，但表明复发风险低的女性可以考虑激素治疗，以平衡症状影响与预后。