<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Terapevticheskii arkhiv</journal-id><journal-title-group><journal-title xml:lang="en">Terapevticheskii arkhiv</journal-title><trans-title-group xml:lang="ru"><trans-title>Терапевтический архив</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0040-3660</issn><issn publication-format="electronic">2309-5342</issn><publisher><publisher-name xml:lang="en">LLC Obyedinennaya Redaktsiya</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">691533</article-id><article-id pub-id-type="doi">10.26442/00403660.2026.01.203470</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Consensuns</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Консенсус</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Menopausal hormone therapy in patients with cardiovascular and metabolic diseases: an interdisciplinary Delphi consensus among Russian gynecologists, cardiologists, endocrinologists, gerontologists and geriatricians, phlebologists, and clinical pharmacologists</article-title><trans-title-group xml:lang="ru"><trans-title>Менопаузальная гормональная терапия у пациенток с сердечно-сосудистыми и метаболическими заболеваниями: междисциплинарный дельфийский консенсус среди российских гинекологов, кардиологов, эндокринологов, геронтологов и гериатров, флебологов, клинических фармакологов</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7712-1260</contrib-id><name-alternatives><name xml:lang="en"><surname>Sukhikh</surname><given-names>Gennadii T.</given-names></name><name xml:lang="ru"><surname>Сухих</surname><given-names>Геннадий Тихонович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>акад. РАН, д-р мед. наук, проф., дир.; зав. каф. акушерства, гинекологии, перинатологии и репродуктологии Института профессионального образования; вице-президент Российского общества акушеров-гинекологов, засл. деят. науки РФ</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2976-7128</contrib-id><name-alternatives><name xml:lang="en"><surname>Serov</surname><given-names>Vladimir N.</given-names></name><name xml:lang="ru"><surname>Серов</surname><given-names>Владимир Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>акад. РАН, д-р мед. наук, проф., гл. науч. сотр. организационно-методического отд. службы научно-организационного обеспечения; президент Российского общества акушеров-гинекологов</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2929-0980</contrib-id><name-alternatives><name xml:lang="en"><surname>Shlyakhto</surname><given-names>Evgeny V.</given-names></name><name xml:lang="ru"><surname>Шляхто</surname><given-names>Евгений Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>акад. РАН, д-р мед. наук, проф., дир.; президент Российского кардиологического общества, засл. деят. науки РФ</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8175-7886</contrib-id><name-alternatives><name xml:lang="en"><surname>Dedov</surname><given-names>Ivan I.</given-names></name><name xml:lang="ru"><surname>Дедов</surname><given-names>Иван Иванович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>акад. РАН, д-р мед. наук, проф., президент; Герой Труда РФ, член Президиума РАН, президент Российской ассоциации эндокринологов, гл. внештатный специалист-эксперт – эндокринолог Минздрава России</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6645-2515</contrib-id><name-alternatives><name xml:lang="en"><surname>Arutyunov</surname><given-names>Gregory P.</given-names></name><name xml:lang="ru"><surname>Арутюнов</surname><given-names>Григорий Павлович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>чл.-кор. РАН, д-р мед. наук, проф., президент Евразийской ассоциации терапевтов, дир. Института клинической медицины, зав. каф. пропедевтики внутренних болезней; засл. врач РФ</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4193-688X</contrib-id><name-alternatives><name xml:lang="en"><surname>Tkacheva</surname><given-names>Olga N.</given-names></name><name xml:lang="ru"><surname>Ткачева</surname><given-names>Ольга Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>чл.-кор. РАН, д-р мед. наук, проф., дир. Российского геронтологического научно-клинического центра; президент Российской ассоциации геронтологов и гериатров, гл. внештатный специалист-гериатр Минздрава России</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0627-3902</contrib-id><name-alternatives><name xml:lang="en"><surname>Smetnik</surname><given-names>Antonina A.</given-names></name><name xml:lang="ru"><surname>Сметник</surname><given-names>Антонина Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>канд. мед. наук, зав. отд-нием гинекологической эндокринологии; президент Российского общества специалистов по гинекологической эндокринологии и менопаузе, член правления Европейского общества по менопаузе и андропаузе, член руководящего комитета по аффилированным ассоциациям при Международном обществе по менопаузе</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1292-5452</contrib-id><name-alternatives><name xml:lang="en"><surname>Suchkov</surname><given-names>Igor A.</given-names></name><name xml:lang="ru"><surname>Сучков</surname><given-names>Игорь Александрович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., проф. каф. сердечно-сосудистой, рентгенэндоваскулярной хирургии и лучевой диагностики; президент Ассоциации флебологов России, действительный член Европейского общества сосудистых хирургов, член правления Российского общества ангиологов и сосудистых хирургов, член Ассоциации сердечно-сосудистых хирургов России</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9813-2823</contrib-id><name-alternatives><name xml:lang="en"><surname>Baranov</surname><given-names>Igor I.</given-names></name><name xml:lang="ru"><surname>Баранов</surname><given-names>Игорь Иванович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., зав. отд. научно-образовательных программ департамента организации научной деятельности; вице-президент Российского общества акушеров-гинекологов</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5057-127X</contrib-id><name-alternatives><name xml:lang="en"><surname>Shestakova</surname><given-names>Marina V.</given-names></name><name xml:lang="ru"><surname>Шестакова</surname><given-names>Марина Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>акад. РАН, д-р мед. наук, проф., дир. Института диабета, зав. каф. диабетологии и диетологии; засл. деят. науки РФ, член президиума правления Российской ассоциации эндокринологов</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5634-7877</contrib-id><name-alternatives><name xml:lang="en"><surname>Mel'nichenko</surname><given-names>Galina A.</given-names></name><name xml:lang="ru"><surname>Мельниченко</surname><given-names>Галина Афанасьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>акад. РАН, д-р мед. наук, проф., зам. дир. по научной работе, зав. каф. клинической эндокринологии; засл. деят. науки РФ</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9299-1053</contrib-id><name-alternatives><name xml:lang="en"><surname>Vasyukova</surname><given-names>Olga V.</given-names></name><name xml:lang="ru"><surname>Васюкова</surname><given-names>Ольга Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>канд. мед. наук, доц. каф. детской эндокринологии-диабетологии, рук. центра лечения и профилактики метаболических заболеваний и ожирения</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7177-0254</contrib-id><name-alternatives><name xml:lang="en"><surname>Sheremetyeva</surname><given-names>Ekaterina V.</given-names></name><name xml:lang="ru"><surname>Шереметьева</surname><given-names>Екатерина Викторовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>канд. мед. наук, вед. науч. сотр. отд-ния эндокринной гинекологии</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8425-0020</contrib-id><name-alternatives><name xml:lang="en"><surname>Andreeva</surname><given-names>Elena N.</given-names></name><name xml:lang="ru"><surname>Андреева</surname><given-names>Елена Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., зам. дир., дир. Института репродуктивной медицины</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6612-6851</contrib-id><name-alternatives><name xml:lang="en"><surname>Shestakova</surname><given-names>Ekaterina A.</given-names></name><name xml:lang="ru"><surname>Шестакова</surname><given-names>Екатерина Алексеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, доц., гл. науч. сотр. отд. прогнозирования и инноваций диабета; проф. каф.</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff4"/><xref ref-type="aff" rid="aff7"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8160-5612</contrib-id><name-alternatives><name xml:lang="en"><surname>Orlova</surname><given-names>Yana A.</given-names></name><name xml:lang="ru"><surname>Орлова</surname><given-names>Яна Артуровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., зав. каф. терапии фак-та фундаментальной медицины, рук. отд. возраст-ассоциированных заболеваний Медицинского научно-образовательного института; засл. врач РФ</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff8"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7652-2962</contrib-id><name-alternatives><name xml:lang="en"><surname>Villevalde</surname><given-names>Svetlana V.</given-names></name><name xml:lang="ru"><surname>Виллевальде</surname><given-names>Светлана Вадимовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., зав. каф. кардиологии фак-та послевузовского и дополнительного образования; член правления Российского кардиологического общества, член правления Общества специалистов по сердечной недостаточности, нач. службы анализа и перспективного планирования Управления по реализации федеральных проектов</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8656-3191</contrib-id><name-alternatives><name xml:lang="en"><surname>Irtyuga</surname><given-names>Olga B.</given-names></name><name xml:lang="ru"><surname>Иртюга</surname><given-names>Ольга Борисовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, доц., проф. каф. кардиологии фак-та послевузовского и дополнительного образования, зам. дир. по клинической работе Института медицинского образования, зав. научно-исследовательской лаб. врожденных и приобретенных пороков сердца</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1534-3965</contrib-id><name-alternatives><name xml:lang="en"><surname>Sergienko</surname><given-names>Igor V.</given-names></name><name xml:lang="ru"><surname>Сергиенко</surname><given-names>Игорь Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., рук. лаб. фенотипов атеросклероза, гл. науч. сотр.</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff9"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2816-1183</contrib-id><name-alternatives><name xml:lang="en"><surname>Yavelov</surname><given-names>Igor S.</given-names></name><name xml:lang="ru"><surname>Явелов</surname><given-names>Игорь Семенович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., рук. отд. фундаментальных и клинических проблем тромбоза при неинфекционных заболеваниях</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff10"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7003-5186</contrib-id><name-alternatives><name xml:lang="en"><surname>Koziolova</surname><given-names>Natalya A.</given-names></name><name xml:lang="ru"><surname>Козиолова</surname><given-names>Наталья Андреевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, проф., зав. каф. пропедевтики внутренних болезней №2; член президиума правления Российского кардиологического общества, президент Пермского краевого кардиологического общества</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff11"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6629-051X</contrib-id><name-alternatives><name xml:lang="en"><surname>Ermakova</surname><given-names>Elena I.</given-names></name><name xml:lang="ru"><surname>Ермакова</surname><given-names>Елена Ивановна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>канд. мед. наук, вед. науч. сотр. отд-ния гинекологической эндокринологии; вице-президент Российского общества специалистов по гинекологической эндокринологии и менопаузе</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7891-6850</contrib-id><name-alternatives><name xml:lang="en"><surname>Dudinskaya</surname><given-names>Ekaterina N.</given-names></name><name xml:lang="ru"><surname>Дудинская</surname><given-names>Екатерина Наильевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, зав. лаб. возрастных метаболических и эндокринных нарушений, проф. каф. болезней старения Института непрерывного образования и профессионального развития</p></bio><email>g_sukhikh@oparina4.ru</email><xref ref-type="aff" rid="aff5"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Sechenov First Moscow State Medical University (Sechenov University)</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Almazov National Medical Research Centre</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Endocrinology Research Centre</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр эндокринологии им. акад. И.И. Дедова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">Pirogov Russian National Research Medical University (Pirogov University)</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России (Пироговский Университет)</institution></aff></aff-alternatives><aff-alternatives id="aff6"><aff><institution xml:lang="en">Pavlov Ryazan State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Рязанский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff7"><aff><institution xml:lang="en">Russian Medical Academy of Continuous Professional Education</institution></aff><aff><institution xml:lang="ru">ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff8"><aff><institution xml:lang="en">Lomonosov Moscow State University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»</institution></aff></aff-alternatives><aff-alternatives id="aff9"><aff><institution xml:lang="en">Chazov National Medical Research Center of Cardiology</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff10"><aff><institution xml:lang="en">National Research Center for Therapy and Preventive Medicine</institution></aff><aff><institution xml:lang="ru">ФГБОУ «Национальный медицинский исследовательский центр терапии и профилактической медицины» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff11"><aff><institution xml:lang="en">Vagner Perm State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е.А. Вагнера»</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-11-07" publication-format="electronic"><day>07</day><month>11</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2026-02-15" publication-format="electronic"><day>15</day><month>02</month><year>2026</year></pub-date><volume>98</volume><issue>1</issue><issue-title xml:lang="en">Outpatient care issues and organization of medical care</issue-title><issue-title xml:lang="ru">Поликлинические проблемы и организация медицинской помощи</issue-title><fpage>6</fpage><lpage>27</lpage><history><date date-type="received" iso-8601-date="2025-09-27"><day>27</day><month>09</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-11-05"><day>05</day><month>11</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Consilium Medicum</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, ООО "Консилиум Медикум"</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Consilium Medicum</copyright-holder><copyright-holder xml:lang="ru">ООО "Консилиум Медикум"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-sa/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://ter-arkhiv.ru/0040-3660/article/view/691533">https://ter-arkhiv.ru/0040-3660/article/view/691533</self-uri><abstract xml:lang="en"><p>More than one million women in Russia enter menopause each year. The severe estrogen deficiency associated with this transition causes symptoms that significantly impair quality of life and contribute to an increased risk of cardiovascular and metabolic diseases. Menopausal hormone therapy (MHT) is the established standard of care for menopausal symptoms. On the initiative of several professional societies (the Russian Society of Obstetricians and Gynecologists, the Russian Society of Cardiology, the Russian Association of Endocrinologists, the Eurasian Association of Therapists, the Russian Society of Gynecological Endocrinology and Menopause, the Russian Association of Gerontologists and Geriatricians, the Association of Phlebologists of Russia), a Delphi panel was convened to develop a multidisciplinary expert consensus on MHT for patients with cardiovascular and metabolic diseases. The goal was to enhance research and clinical approaches to managing menopausal women. A consensus was reached at the end of the first Delphi round. The experts agreed that initiating MHT requires a thorough assessment of individual risks, including cardiovascular health and comorbidities. MHT can offset metabolic and cardiovascular risk factors in peri- and postmenopausal women by normalizing the lipid profile, improving carbohydrate metabolism, and reducing insulin resistance. An interdisciplinary approach allows for personalized MHT, minimizes potential complications, improves the quality of life for peri- and postmenopausal women, and promotes active longevity.</p></abstract><trans-abstract xml:lang="ru"><p>В Российской Федерации ежегодно более 1 млн женщин вступают в менопаузу. Выраженный эстрогенодефицит приводит к развитию симптомов, значимо влияющих на качество их жизни, а также способствующих повышению риска развития сердечно-сосудистых и метаболических заболеваний. Менопаузальная гормональная терапия (МГТ) – признанный стандарт лечения климактерических симптомов. По инициативе профессиональных сообществ (Российского общества акушеров-гинекологов, Российского кардиологического общества, Российской ассоциации эндокринологов, Евразийской ассоциации терапевтов, Российского общества специалистов по гинекологической эндокринологии и менопаузе, Российской ассоциации геронтологов и гериатров, Ассоциации флебологов России) организовано дельфийское голосование для получения согласованного мнения экспертов различных специальностей по отношению к МГТ у пациенток с сердечно-сосудистыми и метаболическими заболеваниями. Целью выступила необходимость совершенствования междисциплинарных научно-практических подходов по ведению женщин с климактерическим синдромом. В результате дельфийский консенсус достигнут по итогу первого раунда. Эксперты пришли к согласованному выводу о том, что назначение МГТ требует тщательной оценки индивидуальных рисков, включая состояние сердечно-сосудистой системы и наличие сопутствующих заболеваний. МГТ может оказывать положительное влияние на метаболические и сердечно-сосудистые факторы риска у женщин в пери- и постменопаузе путем нормализации липидного профиля, улучшения углеводного обмена и снижения инсулинорезистентности. Междисциплинарный подход позволяет персонализировать МГТ, минимизировать возможные осложнения, улучшить качество жизни женщин в пери- и постменопаузе, увеличить продолжительность активного долголетия.</p></trans-abstract><kwd-group xml:lang="en"><kwd>menopausal hormone therapy</kwd><kwd>menopause</kwd><kwd>climacteric syndrome</kwd><kwd>cardiovascular diseases</kwd><kwd>metabolic diseases</kwd><kwd>interdisciplinary consensus</kwd><kwd>Delphi method</kwd><kwd>quality of life</kwd><kwd>active longevity</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>менопаузальная гормональная терапия</kwd><kwd>менопауза</kwd><kwd>климактерический синдром</kwd><kwd>сердечно-сосудистые заболевания</kwd><kwd>метаболические заболевания</kwd><kwd>междисциплинарный консенсус</kwd><kwd>метод Дельфи</kwd><kwd>качество жизни</kwd><kwd>активное долголетие</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>О национальных целях развития Российской Федерации на период до 2030 г. и на перспективу до 2036 г. Указ Президента РФ от 07.05.2024 г. №309. Режим доступа: https://www.consultant.ru/document/cons_doc_LAW_475991. Ссылка активна на 17.09.2025 [O natsional'nykh tseliakh razvitiia Rossiiskoi Federatsii na period do 2030 g. i na perspektivu do 2036 g. Ukaz Prezidenta RF ot 07.05.2024 g. No. 309. Available at: https://www.consultant.ru/document/cons_doc_LAW_475991. Accessed: 17.09.2025 (in Russian)].</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Об утверждении Национальной стратегии действий в интересах женщин на 2023–2030-е гг. Распоряжение Правительства Российской Федерации от 29 декабря 2022 г. №4356-р. Режим доступа: https://www.consultant.ru/document/cons_doc_LAW_436691. Ссылка активна на 17.09.2025 [Ob utverzhdenii Natsional'noi strategii deistvii v interesakh zhenshchin na 2023–2030-e gg. Rasporiazhenie Pravitel'stva Rossiiskoi Federatsii ot 29 dekabria 2022 g. No. 4356-r. Available at: https://www.consultant.ru/document/cons_doc_LAW_436691. Accessed: 17.09.2025 (in Russian)].</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Nappi RE, Kroll R, Siddiqui E, et al. Global cross-sectional survey of women with vasomotor symptoms associated with menopause: prevalence and quality of life burden. Menopause. 2021;28(8):875-82. DOI:10.1097/GME.0000000000001793</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Panay N, Palacios S, Davison S, Baber R. Women’s perception of the menopause transition: a multinational, prospective, community-based survey. GREM Gynecological and Reproductive. Endocrinology &amp; Metabolism. 2021;2(3):178-83. DOI:10.53260/GREM.212037</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Motlani V, Motlani G, Pamnani S, et al. Endocrine Changes in Postmenopausal Women: A Comprehensive View. Cureus. 2023;15(12):e51287. DOI:10.7759/cureus.51287</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>el Khoudary SR, Aggarwal B, Beckie TM, et al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020;142(25):e506-52. DOI:10.1161/CIR.0000000000000912</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Thurston RC, Aslanidou Vlachos HE, Derby CA, et al. Menopausal Vasomotor Symptoms and Risk of Incident Cardiovascular Disease Events in SWAN. J Am Heart Assoc. 2021;10(3):e017416. DOI:10.1161/JAHA.120.017416</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Zhang K, Ma Y, Luo Y, et al. Metabolic diseases and healthy aging: identifying environmental and behavioral risk factors and promoting public health. Front Public Health. 2023;11:1253506. DOI:10.3389/fpubh.2023.1253506</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;143(21):e984-e1010. DOI:10.1161/CIR.0000000000000973</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Rosengren A, Dikaiou P. Cardiovascular outcomes in type 1 and type 2 diabetes. Diabetologia. 2023;66(3):425-37. DOI:10.1007/s00125-022-05857-5</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their Management. Endocrinol Metab Clin North Am. 2015;44(3):497-515. DOI:10.1016/j.ecl.2015.05.001</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Thurston RC, Joffe H. Vasomotor symptoms and menopause: findings from the Study of Women's Health across the Nation. Obstet Gynecol Clin North Am. 2011;38(3):489-501. DOI:10.1016/j.ogc.2011.05.006</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Шляхто Е.В., Сухих Г.Т., Серов В.Н., и др. Российские критерии приемлемости назначения менопаузальной гормональной терапии пациенткам с сердечно-сосудистыми и метаболическими заболеваниями. Согласительный документ РКО, РОАГ, РАЭ, ЕАТ, РАФ. Проблемы Эндокринологии. 2023;69(5):115-36 [Shlyakhto EV, Sukhikh GT, Serov VN, et al. Russian eligibility criteria prescribing menopausal hormonal hormones therapy for patients with cardiovascular and metabolic diseases. Consensus document of the Russian Cardiological Society, Russian Society of Obstetricians and Gynecologists, Russian Association of Endocrinologists, Eurasian Association of Therapists, Association of Phlebologists of Russia. Problems of Endocrinology. 2023;69(5):115-36 (in Russian)]. DOI:10.14341/probl13394</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Менопауза и климактерическое состояние у женщины. Клинические рекомендации Российского общества акушеров-гинекологов, одобренные Научно-практическим Советом Минздрава России. 2021. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/117_2. Ссылка активна на 17.09.2025 [Menopauza i klimaktericheskoe sostoianie u zhenshchiny. Klinicheskie rekomendatsii Rossiiskogo obshchestva akusherov-ginekologov, odobrennye Nauchno-prakticheskim Sovetom Minzdrava Rossii. 2021. Available at: https://cr.minzdrav.gov.ru/preview-cr/117_2. Accessed: 17.09.2025 (in Russian)].</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Кобалава Ж.Д., Конради А.О., Недогода С.В., и др. Артериальная гипертензия у взрослых. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(9):6117 [Kobalava ZD, Konradi AO, Nedogoda SV, et al. 2024 Clinical practice guidelines for Hypertension in adults. Russian Journal of Cardiology. 2024;29(9):6117 (in Russian)]. DOI:10.15829/1560-4071-2024-6117</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Marjoribanks J, Farquhar C, Roberts H, et al. Long-term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2017;1(1):CD004143. DOI:10.1002/14651858.CD004143.pub5</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>US Preventive Services Task Force, Grossman DC, Curry SJ, Owens DK, et al. Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement. JAMA. 2017;318(22):2224-323. DOI:10.1001/jama.2017.18261</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Mendoza N, Ramírez I, de la Viuda E, et al. Eligibility criteria for Menopausal Hormone Therapy (MHT): a position statement from a consortium of scientific societies for the use of MHT in women with medical conditions. MHT Eligibility Criteria Group. Maturitas. 2022;166:65-85. DOI:10.1016/j.maturitas.2022.08.008</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Panay N, Ang SB, Cheshire R, et al. Menopause and MHT in 2024: addressing the key controversies – an International Menopause Society White Paper. Climacteric. 2024;27(5):441-57. DOI:10.1080/13697137.2024.2394950</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Manson JE, Aragaki AK, Rossouw JE, et al. Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials. JAMA. 2017;318(10):927-38. DOI:10.1001/jama.2017.11217</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Prentice RL, Aragaki AK, Chlebowski RT, et al. Randomized Trial Evaluation of the Benefits and Risks of Menopausal Hormone Therapy Among Women 50-59 Years of Age. Am J Epidemiol. 2021;190(3):365-75. DOI:10.1093/aje/kwaa210</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Cobin RH, Goodman NF; American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement on Menopause–2017 Update. Endocrine Practice. 2017;23(7):869-80. DOI:10.4158/ep171828.ps</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Cho L, Kaunitz AM, Faubion SS, et al. Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long? Circulation. 2023;147(7):597-610. DOI:10.1161/CIRCULATIONAHA.122.061559</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Levy B, Simon JA. A Contemporary View of Menopausal Hormone Therapy. Obstet Gynecol. 2024;144(1):12-23. DOI:10.1097/AOG.0000000000005553</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Maas AHEM, Rosano G, Cifkova R, et al. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists. Eur Heart J. 2021;42(10):967-84. DOI:10.1093/eurheartj/ehaa1044</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Colacurci N, Filardi PP, Chiantera A, et al. Sharing the multidisciplinary clinical approach to peri- and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice. Int J Gynaecol Obstet. 2024;166(2):682-91. DOI:10.1002/ijgo.15448</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Jones J, Hunter D. Consensus methods for medical and health services research. BMJ. 1995;311(7001):376-80. DOI:10.1136/bmj.311.7001.376</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Diamond IR, Grant RC, Feldman BM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67(4):401-9. DOI:10.1016/j.jclinepi.2013.12.002</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Rowe G, Wright G. The Delphi technique as a forecasting tool: issues and analysis. International Journal of Forecasting. 2002;15(4):353-75. DOI:10.1016/s0169-2070(99)00018-7</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Fitch K, Bernstein S, Aguilar M, et al. The Rand/UCLA Appropriateness Method User’s Manual. 2001.</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>Inaraja V, Thuissard I, Andreu-Vazquez C, Jodar E. Lipid profile changes during the menopausal transition. Menopause. 2020;27(7):780-8. DOI:10.1097/GME.0000000000001532</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Benjamin EJ, Muntner P, Alonso A, et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139(10):e56-e528. DOI:10.1161/CIR.0000000000000659</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Xie W, Wang Y, Xiao S, et al. Association of gestational diabetes mellitus with overall and type specific cardiovascular and cerebrovascular diseases: systematic review and meta-analysis. BMJ. 2022;378:e070244. DOI:10.1136/bmj-2022-070244</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Wu P, Haththotuwa R, Kwok CS, et al. Preeclampsia and Future Cardiovascular Health: A Systematic Review and Meta-Analysis. Circ Cardiovasc Qual Outcomes. 2017;10(2):e003497. DOI:10.1161/CIRCOUTCOMES.116.003497</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Larsen EC, Christiansen OB, Kolte AM, Macklon N. New insights into mechanisms behind miscarriage. BMC Med. 2013;11:154. DOI:10.1186/1741-7015-11-154</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>Melo P, Dhillon-Smith R, Islam MA, et al. Genetic causes of sporadic and recurrent miscarriage. Fertil Steril. 2023;120(5):940-4. DOI:10.1016/j.fertnstert.2023.08.952</mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation>Quesada O. Reproductive risk factors for cardiovascular disease in women. Menopause. 2023;30(10):1058-60. DOI:10.1097/GME.0000000000002264</mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation>SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42(25):2439-54. DOI:10.1093/eurheartj/ehab309</mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation>Baber RJ, Panay N, Fenton A. IMS Writing Group. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016;19(2):109-50. DOI:10.3109/13697137.2015.1129166</mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation>National Institute for Health and Care Excellence (NICE). Menopause: Identification and Management. 2024. Available at: https://www.nice.org.uk/guidance/ng23. Accessed: 17.09.2025.</mixed-citation></ref><ref id="B41"><label>41.</label><mixed-citation>ACOG committee opinion no. 556: Postmenopausal estrogen therapy: route of administration and risk of venous thromboembolism. Obstet Gynecol. 2013;121(4):887-90. DOI:10.1097/01.AOG.0000428645.90795.d9</mixed-citation></ref><ref id="B42"><label>42.</label><mixed-citation>Lambrinoudaki I, Armeni E, Goulis D, et al. Menopause, wellbeing and health: A care pathway from the European Menopause and Andropause Society. Maturitas. 2022;163:1-14. DOI:10.1016/j.maturitas.2022.04.008</mixed-citation></ref><ref id="B43"><label>43.</label><mixed-citation>Genazzani AR, Divakar H, Khadilkar SS, et al. Counseling in menopausal women: How to address the benefits and risks of menopause hormone therapy. A FIGO position paper. Int J Gynaecol Obstet. 2024;164(2):516-30. DOI:10.1002/ijgo.15278</mixed-citation></ref><ref id="B44"><label>44.</label><mixed-citation>Ang SB, Sugianto SRS, Tan FCJH, et al. Asia-Pacific Menopause Federation Consensus Statement on the Management of Menopause 2024. J Menopausal Med. 2025;31(1):3-11. DOI:10.6118/jmm.25104</mixed-citation></ref><ref id="B45"><label>45.</label><mixed-citation>The 2022 Hormone Therapy Position Statement of The North American Menopause Society Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-94. DOI:10.1097/GME.0000000000002028</mixed-citation></ref><ref id="B46"><label>46.</label><mixed-citation>Zhu D, Chung HF, Dobson AJ, et al. Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies. Am J Obstet Gynecol. 2020;223(6):898.e1-898.e16. DOI:10.1016/j.ajog.2020.06.039</mixed-citation></ref><ref id="B47"><label>47.</label><mixed-citation>Nilsson S, Qvick A, Henriksson M, et al. Menopausal Vasomotor Symptoms and Subclinical Atherosclerotic Cardiovascular Disease: A Population-Based Study. J Am Heart Assoc. 2024;13(17):e033648. DOI:10.1161/JAHA.123.033648</mixed-citation></ref><ref id="B48"><label>48.</label><mixed-citation>Tuomikoski P, Savolainen-Peltonen H. Vasomotor symptoms and metabolic syndrome. Maturitas. 2017;97:61-5. DOI:10.1016/j.maturitas.2016.12.010</mixed-citation></ref><ref id="B49"><label>49.</label><mixed-citation>Thurston RC, El Khoudary SR, Sutton-Tyrrell K, et al. Vasomotor symptoms and insulin resistance in the study of women's health across the nation. J Clin Endocrinol Metab. 2012;97(10):3487-94. DOI:10.1210/jc.2012-1410</mixed-citation></ref><ref id="B50"><label>50.</label><mixed-citation>Cappola AR, Auchus RJ, El-Hajj Fuleihan G, et al. Hormones and Aging: An Endocrine Society Scientific Statement. J Clin Endocrinol Metab. 2023;108(8):1835-74. DOI:10.1210/clinem/dgad225</mixed-citation></ref><ref id="B51"><label>51.</label><mixed-citation>Munir JA, Wu H, Bauer K, et al. The perimenopausal atherosclerosis transition. Menopause. 2012;19(1):10-5. DOI:10.1097/gme.0b013e318221bc8d</mixed-citation></ref><ref id="B52"><label>52.</label><mixed-citation>Ofori EK, Conde Alonso S, Correas-Gomez L, et al. Thigh and abdominal adipose tissue depot associations with testosterone levels in postmenopausal females. Clin Endocrinol (Oxf). 2019;90(3):433-3. DOI:10.1111/cen.13921</mixed-citation></ref><ref id="B53"><label>53.</label><mixed-citation>Simon JA. Estrogen replacement therapy: effects on the endogenous androgen milieu. Fertil Steril. 2002;77(Suppl. 4):S77-82. DOI:10.1016/s0015-0282(02)02986-2</mixed-citation></ref><ref id="B54"><label>54.</label><mixed-citation>Worsley R, Robinson PJ, Bell RJ, et al. Endogenous estrogen and androgen levels are not independent predictors of lipid levels in postmenopausal women. Menopause. 2013;20(6):640-5. DOI:10.1097/GME.0b013e318279bd4a</mixed-citation></ref><ref id="B55"><label>55.</label><mixed-citation>Tang Y, Ma R, Zhang L, et al. Effectiveness and safety of hormone replacement therapy in the treatment of menopausal syndrome: a meta-analysis. Am J Transl Res. 2025;17(1):1-15. DOI:10.62347/UGLT3830</mixed-citation></ref><ref id="B56"><label>56.</label><mixed-citation>Sharma A, Welt CK. Practical Approach to Hyperandrogenism in Women. Med Clin North Am. 2021;105(6):1099-116. DOI:10.1016/j.mcna.2021.06.008</mixed-citation></ref><ref id="B57"><label>57.</label><mixed-citation>Sievers C, Klotsche J, Pieper L, et al. Low testosterone levels predict all-cause mortality and cardiovascular events in women: a prospective cohort study in German primary care patients. Eur J Endocrinol. 2010;163(4):699-708. DOI:10.1530/EJE-10-0307</mixed-citation></ref><ref id="B58"><label>58.</label><mixed-citation>Osmancevic A, Allison M, Miljkovic I, et al. Exploring the Relationships between Sex Hormones and Abdominal Muscle Area and Radiodensity in Postmenopausal Women: Insights from the Multi-Ethnic Study of Atherosclerosis. Maturitas. 2025;194:108197. DOI:10.1016/j.maturitas.2025.108197</mixed-citation></ref><ref id="B59"><label>59.</label><mixed-citation>Cushman M, Kuller LH, Prentice R, et al. Estrogen plus progestin and risk of venous thrombosis. JAMA. 2004;292(13):1573-80. DOI:10.1001/jama.292.13.1573</mixed-citation></ref><ref id="B60"><label>60.</label><mixed-citation>Canonico M, Oger E, Plu-Bureau G, et al. Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation. 2007;115(7):840-5. DOI:10.1161/CIRCULATIONAHA.106.642280</mixed-citation></ref><ref id="B61"><label>61.</label><mixed-citation>Sweetland S, Beral V, Balkwill A, et al. Venous thromboembolism risk in relation to use of different types of postmenopausal hormone therapy in a large prospective study. J Thromb Haemost. 2012;10(11):2277-86. DOI:10.1111/j.1538-7836.2012.04919.x</mixed-citation></ref><ref id="B62"><label>62.</label><mixed-citation>Scarabin PY, Oger E, Plu-Bureau G. EStrogen and THromboEmbolism Risk Study Group. Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk. Lancet. 2003;362(9382):428-32. DOI:10.1016/S0140-6736(03)14066-4</mixed-citation></ref><ref id="B63"><label>63.</label><mixed-citation>Canonico M, Fournier A, Carcaillon L, et al. Postmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study. Arterioscler Thromb Vasc Biol. 2010;30(2):340-5. DOI:10.1161/ATVBAHA.109.196022</mixed-citation></ref><ref id="B64"><label>64.</label><mixed-citation>Simon JA, Laliberté F, Duh MS, et al. Venous thromboembolism and cardiovascular disease complications in menopausal women using transdermal versus oral estrogen therapy. Menopause. 2016;23(6):600-10. DOI:10.1097/GME.0000000000000590</mixed-citation></ref><ref id="B65"><label>65.</label><mixed-citation>Douketis JD, Julian JA, Crowther MA, et al. The effect of prothrombotic blood abnormalities on risk of deep vein thrombosis in users of hormone replacement therapy: a prospective case-control study. Clin Appl Thromb Hemost. 2011;17(6):E106-13. DOI:10.1177/1076029610387587</mixed-citation></ref><ref id="B66"><label>66.</label><mixed-citation>Herrington DM, Vittinghoff E, Howard TD, et al. Factor V Leiden, hormone replacement therapy, and risk of venous thromboembolic events in women with coronary disease. Arterioscler Thromb Vasc Biol. 2002;22(6):1012-7. DOI:10.1161/01.atv.0000018301.91721.94</mixed-citation></ref><ref id="B67"><label>67.</label><mixed-citation>Høibraaten E, Qvigstad E, Andersen TO, et al. The effects of hormone replacement therapy (HRT) on hemostatic variables in women with previous venous thromboembolism – results from a randomized, double-blind, clinical trial. Thromb Haemost. 2001;85(5):775-81.</mixed-citation></ref><ref id="B68"><label>68.</label><mixed-citation>Høibraaten E, Qvigstad E, Arnesen H, et al. Increased risk of recurrent venous thromboembolism during hormone replacement therapy – results of the randomized, double-blind, placebo-controlled estrogen in venous thromboembolism trial (EVTET). Thromb Haemost. 2000;84(6):961-7.</mixed-citation></ref><ref id="B69"><label>69.</label><mixed-citation>Lowe G, Woodward M, Vessey M, et al. Thrombotic variables and risk of idiopathic venous thromboembolism in women aged 45-64 years. Relationships to hormone replacement therapy. Thromb Haemost. 2000;83(4):530-5.</mixed-citation></ref><ref id="B70"><label>70.</label><mixed-citation>Olié V, Plu-Bureau G, Conard J, et al. Hormone therapy and recurrence of venous thromboembolism among postmenopausal women. Menopause. 2011;18(5):488-93. DOI:10.1097/gme.0b013e3181f9f7c3</mixed-citation></ref><ref id="B71"><label>71.</label><mixed-citation>Rosendaal FR, Vessey M, Rumley A, et al. Hormonal replacement therapy, prothrombotic mutations and the risk of venous thrombosis. Br J Haematol. 2002;116(4):851-4. DOI:10.1046/j.0007-1048.2002.03356.x</mixed-citation></ref><ref id="B72"><label>72.</label><mixed-citation>Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002;288(3):321-33. DOI:10.1001/jama.288.3.321</mixed-citation></ref><ref id="B73"><label>73.</label><mixed-citation>Straczek C, Oger E, Yon de Jonage-Canonico MB, et al. Prothrombotic mutations, hormone therapy, and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration. Circulation. 2005;112(22):3495-500. DOI:10.1161/CIRCULATIONAHA.105.565556</mixed-citation></ref><ref id="B74"><label>74.</label><mixed-citation>Сметник А.А., Иванов И.А., Ермакова Е.И., Табеева Г.И. Особенности использования менопаузальной гормональной терапии в России: результаты масштабного опроса женщин в пери- и постменопаузе. Акушерство и гинекология. 2025;8:196-208 [Smetnik AA, Ivanov IA, Ermakova EI, Tabeeva GI. Specific features of menopausal hormone therapy use in Russia: results of a large-scale survey among peri- and postmenopausal women. Obstetrics and Gynecology. 2025;8:196-208 (in Russian)]. DOI:10.18565/aig.2025.200</mixed-citation></ref><ref id="B75"><label>75.</label><mixed-citation>Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ. 2019;364:k4810. DOI:10.1136/bmj.k4810</mixed-citation></ref><ref id="B76"><label>76.</label><mixed-citation>Smith NL, Blondon M, Wiggins KL, et al. Lower risk of cardiovascular events in postmenopausal women taking oral estradiol compared with oral conjugated equine estrogens. JAMA Intern Med. 2014;174(1):25-31. DOI:10.1001/jamainternmed.2013.11074</mixed-citation></ref><ref id="B77"><label>77.</label><mixed-citation>Blondon M, Timmons AK, Baraff AJ, et al. Comparative venous thromboembolic safety of oral and transdermal postmenopausal hormone therapies among women Veterans. Menopause. 2021;28(10):1125-19. DOI:10.1097/GME.0000000000001823</mixed-citation></ref><ref id="B78"><label>78.</label><mixed-citation>Tatarchuk T, Stevenson JC, Yu Q, et al. Ultra-low-dose continuous combined estradiol and dydrogesterone in postmenopausal women: A pooled safety and tolerability analysis. Gynecol Endocrinol. 2024;40(1):2375577. DOI:10.1080/09513590.2024.2375577</mixed-citation></ref><ref id="B79"><label>79.</label><mixed-citation>Ren M, Yu Q, Custodio MG, et al. Low-dose and ultra-low-dose estradiol and dydrogesterone in postmenopause: an analysis by body mass index. Climacteric. 2025;28(1):21-7. DOI:10.1080/13697137.2024.2418497</mixed-citation></ref><ref id="B80"><label>80.</label><mixed-citation>Jeong HG, Park H. Metabolic Disorders in Menopause. Metabolites. 2022;12(10):954. DOI:10.3390/metabo12100954</mixed-citation></ref><ref id="B81"><label>81.</label><mixed-citation>Li YM, Lei X, Yu LL. Management of menopausal syndrome in women with dyslipidemia. Zhonghua Yu Fang Yi Xue Za Zhi. 2023;57(11):1908-94 (in Chinese). DOI:10.3760/cma.j.cn112150-20221216-01208</mixed-citation></ref><ref id="B82"><label>82.</label><mixed-citation>Anagnostis P, Stevenson JC, Crook D, et al. Effects of menopause, gender and age on lipids and high-density lipoprotein cholesterol subfractions. Maturitas. 2015;81(1):62-8. DOI:10.1016/j.maturitas.2015.02.262</mixed-citation></ref><ref id="B83"><label>83.</label><mixed-citation>Polyzos SA, Goulis DG. Menopause and metabolic dysfunction-associated steatotic liver disease. Maturitas. 2024;186:108024. DOI:10.1016/j.maturitas.2024.108024</mixed-citation></ref><ref id="B84"><label>84.</label><mixed-citation>Darvish S, Murray KO, Ludwig KR, et al. Preservation of Vascular Endothelial Function in Late-Onset Postmenopausal Women. Circ Res. 2025;136(5):455-69. DOI:10.1161/CIRCRESAHA.124.325639</mixed-citation></ref><ref id="B85"><label>85.</label><mixed-citation>Salpeter SR, Walsh JM, Ormiston TM, et al. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes Obes Metab. 2006;8(5):538-54. DOI:10.1111/j.1463-1326.2005.00545.x</mixed-citation></ref><ref id="B86"><label>86.</label><mixed-citation>Mauvais-Jarvis F, Manson JE, Stevenson JC, Fonseca VA. Menopausal Hormone Therapy and Type 2 Diabetes Prevention: Evidence, Mechanisms, and Clinical Implications. Endocr Rev. 2017;38(3):173-88. DOI:10.1210/er.2016-1146</mixed-citation></ref><ref id="B87"><label>87.</label><mixed-citation>de Lauzon-Guillain B, Fournier A, Fabre A, et al. Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) cohort. Diabetologia. 2009;52(10):2092-100. DOI:10.1007/s00125-009-1456-y</mixed-citation></ref><ref id="B88"><label>88.</label><mixed-citation>Li T, Jiang NS, Kaskey J, et al. Hormone therapy and insulin resistance in non-diabetic postmenopausal women: a systematic review and meta-analysis. Climacteric. 2025;28(6):673-81. DOI:10.1080/13697137.2025.2509844</mixed-citation></ref><ref id="B89"><label>89.</label><mixed-citation>Goodman MP. Are all estrogens created equal? A review of oral vs. transdermal therapy. J Womens Health (Larchmt). 2012;21(2):161-9. DOI:10.1089/jwh.2011.2839</mixed-citation></ref><ref id="B90"><label>90.</label><mixed-citation>Piróg M, Jach R, Undas A. Effects of ultra-low-dose versus standard hormone therapy on fibrinolysis and thrombin generation in postmenopausal women. Eur J Obstet Gynecol Reprod Biol. 2017;217:77-82. DOI:10.1016/j.ejogrb.2017.08.023</mixed-citation></ref><ref id="B91"><label>91.</label><mixed-citation>dos Reis CM, de Melo NR, Meirelles ES, et al. Body composition, visceral fat distribution and fat oxidation in postmenopausal women using oral or transdermal oestrogen. Maturitas. 2003;46(1):59-68. DOI:10.1016/s0378-5122(03)00159-2</mixed-citation></ref><ref id="B92"><label>92.</label><mixed-citation>Spencer CP, Godsland IF, Cooper AJ, et al. Effects of oral and transdermal 17beta-estradiol with cyclical oral norethindrone acetate on insulin sensitivity, secretion, and elimination in postmenopausal women. Metabolism. 2000;49(6):742-7. DOI:10.1053/meta.2000.6238</mixed-citation></ref><ref id="B93"><label>93.</label><mixed-citation>Mikkola TS, Clarkson TB. Estrogen replacement therapy, atherosclerosis, and vascular function. Cardiovasc Res. 2002;53(3):605-19. DOI:10.1016/s0008-6363(01)00466-7</mixed-citation></ref><ref id="B94"><label>94.</label><mixed-citation>Nie G, Yang X, Wang Y, et al. The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis. Front Pharmacol. 2022;13:850815. DOI:10.3389/fphar.2022.850815</mixed-citation></ref><ref id="B95"><label>95.</label><mixed-citation>Speksnijder EM, Ten Noever de Brauw GV, Malekzadeh A, et al. Effect of Postmenopausal Hormone Therapy on Glucose Regulation in Women With Type 1 or Type 2 Diabetes: A Systematic Review and Meta-analysis. Diabetes Care. 2023;46(10):1866-85. DOI:10.2337/dc23-0451</mixed-citation></ref><ref id="B96"><label>96.</label><mixed-citation>Улумбекова Г.Э., Худова И.Ю. Оценка демографического, социального и экономического эффекта при приеме менопаузальной гормональной терапии. ОРГЗДРАВ: новости, мнения, обучение. Вестник ВШОУЗ. 2020;6(4):23-53 [Ulumbekova GE, Khudova IYu. Assessment of the demographic, social, and economic impact of menopausal hormone therapy. Health Care Management: News, Opinions, Training. Bulletin of the Higher School of Health Administration. 2020;6(4):23-53 (in Russian)].</mixed-citation></ref><ref id="B97"><label>97.</label><mixed-citation>Барбараш О.Л., Карпов Ю.А., Панов А.В., и др. Стабильная ишемическая болезнь сердца. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(9):6110 [Barbarash OL, Karpov YA, Panov AV, et al. 2024 Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2024;29(9):6110 (in Russian)]. DOI:10.15829/1560-4071-2024-6110</mixed-citation></ref><ref id="B98"><label>98.</label><mixed-citation>Дедов И.И., Шестакова М.В., Викулова О.К., и др. Сахарный диабет в Российской Федерации: динамика эпидемиологических показателей по данным Федерального регистра сахарного диабета за период 2010 – 2022 гг. Сахарный диабет. 2023;26(2):104-23 [Dedov II, Shestakova MV, Vikulova OK, et al. Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010–2022. Diabetes Mellitus. 2023;26(2):104-23 (in Russian)]. DOI:10.14341/dm13035</mixed-citation></ref><ref id="B99"><label>99.</label><mixed-citation>Драпкина О.М., Концевая А.В., Калинина А.М., и др. Профилактика хронических неинфекционных заболеваний в Российской Федерации. Национальное руководство 2022. Кардиоваскулярная терапия и профилактика. 2022;21(4):3235 [Drapkina OM, Kontsevaya AV, Kalinina AM, et al. 2022 Prevention of chronic non-communicable diseases in the Russian Federation. National guidelines. Cardiovascular Therapy and Prevention. 2022;21(4):3235 (in Russian)]. DOI:10.15829/1728-8800-2022-3235</mixed-citation></ref><ref id="B100"><label>100.</label><mixed-citation>Crandall CJ, Hovey KM, Andrews C, et al. Comparison of clinical outcomes among users of oral and transdermal estrogen therapy in the Women's Health Initiative Observational Study. Menopause. 2017;24(10):1145-53. DOI:10.1097/GME.0000000000000899</mixed-citation></ref><ref id="B101"><label>101.</label><mixed-citation>Opoku AA, Abushama M, Konje JC. Obesity and menopause. Best Pract Res Clin Obstet Gynaecol. 2023;88:102348. DOI:10.1016/j.bpobgyn.2023.102348</mixed-citation></ref><ref id="B102"><label>102.</label><mixed-citation>Трошина Е.А., Паневин Т.С., Брискман Т.Д. Роль ожирения в развитии и прогрессировании остеоартрита: влияние медикаментозных и хирургических методов лечения ожирения на течение воспалительных заболеваний суставов. Терапевтический архив. 2025;97(5):449-54 [Troshina EA, Panevin TS, Briskman TD. The role of obesity in the development and progression of osteoarthritis: the influence of medical and surgical therapies for obesity on the course of inflammatory arthritis: A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2025;97(5):449-54 (in Russian)]. DOI:10.26442/00403660.2025.05.203230</mixed-citation></ref><ref id="B103"><label>103.</label><mixed-citation>Canonico M, Oger E, Conard J, et al. Obesity and risk of venous thromboembolism among postmenopausal women: differential impact of hormone therapy by route of estrogen administration. The ESTHER Study. J Thromb Haemost. 2006;4(6):1259-65. DOI:10.1111/j.1538-7836.2006.01933.x</mixed-citation></ref><ref id="B104"><label>104.</label><mixed-citation>Hicks A, Robson D, Tellis B, et al. Safety of menopause hormone therapy in postmenopausal women at higher risk of venous thromboembolism: a systematic review. Climacteric. 2025;28(5):497-509. DOI:10.1080/13697137.2025.2503874</mixed-citation></ref></ref-list></back></article>
