Hormone replacement therapy (HRT) remains a cornerstone treatment for well-defined endocrine deficiencies and a growing element of regenerative medicine programs that aim to restore function, reduce symptoms, and improve quality of life. This evidence-based article summarizes current indications, clinical outcomes, and safety data for HRT in both women (menopausal/menopausal hormone therapy) and men (testosterone replacement), then links that evidence to practical regenerative-medicine pathways and patient selection.
Regenerative medicine emphasizes restoring physiological function rather than only treating symptoms. When hormonal deficits drive tissue dysfunction (bone loss, sarcopenia, severe vasomotor symptoms, sexual dysfunction), targeted hormone replacement can be a regenerative component by reversing deficits that impair healing, metabolism, and functional recovery. Use HRT only when clear biochemical deficiency or guideline-based indications exist; indiscriminate use confers risk. PMC+1
HRT is the most effective treatment for moderate-to-severe vasomotor symptoms (hot flashes/night sweats) and is effective for genitourinary syndrome of menopause and prevention of bone loss in appropriate patients. Current guideline reviews emphasize individualized use based on age, time since menopause, and risk profile. Short-term use for symptom control in women older than ~50 or within 10 years of menopause often shows favorable benefit–risk balance. PMC+1
Estrogen-containing HRT reduces bone loss and fracture risk in postmenopausal women; however, long-term use decisions should weigh alternative osteoporosis-specific therapies and individual risk factors. AACE+1
For men with documented hypogonadism (consistent symptoms and low serum testosterone confirmed on repeated testing), testosterone replacement improves sexual function, lean body mass, bone density, and some measures of quality of life. Current clinical practice guidelines recommend biochemical confirmation and careful monitoring. Recent randomized trials indicate no clear excess of major adverse cardiovascular events when therapy is used appropriately and monitored. Endocrine+1
Cardiovascular risk: Landmark trials (e.g., WHI for women) initially raised cardiovascular and thromboembolic concerns for combined estrogen–progestin regimens. Later analyses suggest risk depends on age, timing since menopause, hormone formulation, dose, and route (transdermal vs oral). Clinicians should individualize therapy and consider transdermal routes for some patients to reduce thrombotic risk. PMC+1
Breast cancer risk: Some HRT regimens (combined estrogen–progestin) have been associated with modest increases in breast cancer incidence in some trials; estrogen-alone regimens show different patterns depending on patient history (e.g., prior hysterectomy). Discuss screening and duration with patients. PMC
Testosterone safety: Provide therapy only for documented hypogonadism. Monitor hemoglobin, lipids, PSA (where indicated), and blood pressure. Regulatory agencies continue to refine labeling and warnings based on evolving evidence. Reuters+1
Confirm diagnosis — use guideline-based biochemical thresholds and symptom inventories before initiating therapy. Endocrine
Risk stratify — age, smoking, thrombosis history, breast cancer risk, cardiovascular disease. Choose formulation accordingly. PMC
Start lowest effective dose and select route (transdermal vs oral for estrogen; gels/long-acting injections vs patches for testosterone) to match goals and risk profile. Endocrine+1
Monitor regularly — labs and symptom response at baseline, 3–6 months, then annually or as indicated. Titrate or stop if risks/side effects appear. Endocrine
Postoperative bone and muscle optimization: In patients with proven deficiency and high fracture risk or sarcopenia, HRT can be one component of a multimodal regenerative plan that includes nutrition, resistance training, and bone-directed therapies. AACE
Quality-of-life restoration: Treating severe menopausal vasomotor and genitourinary symptoms can enable participation in rehabilitation programs, improving overall functional recovery. Endocrine
“Age-related” hormone prescriptions without clear deficiency remain controversial and risky. Rising public demand, driven by social media and lifestyle marketing, has led to inappropriate prescriptions—clinicians must resist non–evidence-based trends. The Guardian+1
Long-term safety data gaps persist for some formulations and patient subgroups; use shared decision-making and up-to-date guideline references. ScienceDirect