Every woman who lives past midlife will experience menopause, which, by definition, is complete cessation of ovarian function. This process might occur spontaneously (natural menopause) or be iatrogenic (secondary menopause), and can be further classified as ‘early’ if it occurs before the age of 45 years and ‘premature’ if it occurs before the age of 40 years. Globally, the mean age of natural menopause is 48.8 years, with remarkably little geographic variation. A woman’s age at menopause influences health outcomes in later life. Early menopause is associated with a reduced risk of breast cancer, but increased risks of premature osteoporosis, cardiovascular disease and premature death. The cardinal symptoms of menopause, and adverse health sequelae, are due to loss of ovarian oestrogen production. Consequently, menopausal hormone therapy (MHT) that includes oestrogen or an oestrogenic compound ameliorates menopausal symptoms, while preventing menopause-associated bone loss and cardiometabolic changes. Importantly, comprehensive care of postmenopausal women involves lifestyle optimization (attention to nutrition and physical activity, reducing alcohol consumption and not smoking) and treating other established chronic disease risk factors. This Review offers a commentary specifically on the contemporary use of MHT and novel pharmaceutical alternatives to manage menopausal symptoms.

每个过了中年的女性都会经历更年期，根据定义，更年期是卵巢功能完全停止。该过程可能自发发生（自然绝经）或医源性（继发性绝经），如果发生在 45 岁之前，则可进一步归类为“早期”，如果发生在 40 岁之前，则可进一步归类为“过早”。在全球范围内，自然绝经的平均年龄为 48.8 岁，地理差异非常小。女性绝经的年龄会影响以后生活中的健康结果。提前绝经与降低患乳腺癌的风险有关，但会增加过早骨质疏松症、心血管疾病和过早死亡的风险。更年期的主要症状和不利的健康后遗症是由于卵巢雌激素产生的丧失。最后，包括雌激素或雌激素化合物在内的更年期激素疗法 (MHT) 可改善更年期症状，同时防止与更年期相关的骨质流失和心脏代谢变化。重要的是，绝经后妇女的综合护理包括优化生活方式（注意营养和身体活动、减少饮酒和不吸烟）和治疗其他已确定的慢性病风险因素。这篇综述专门针对当代使用 MHT 和新型药物替代品来管理更年期症状提供了评论。绝经后妇女的综合护理包括优化生活方式（注意营养和身体活动、减少饮酒和不吸烟）和治疗其他已确定的慢性病风险因素。这篇综述专门针对当代使用 MHT 和新型药物替代品来管理更年期症状提供了评论。绝经后妇女的综合护理包括优化生活方式（注意营养和身体活动、减少饮酒和不吸烟）和治疗其他已确定的慢性病风险因素。这篇综述专门针对当代使用 MHT 和新型药物替代品来管理更年期症状提供了评论。