What is the safest and most effective option for managing menopausal symptoms in a woman with controlled hypertension?

Combination hormone therapy can be considered a safe and effective option for managing menopausal symptoms in women, especially those who may also require additional symptom relief beyond what estrogen alone provides. This therapy typically involves the administration of both estrogen and progesterone, which can help alleviate symptoms such as hot flashes, night sweats, and vaginal dryness while protecting against the risks associated with unopposed estrogen therapy in women with an intact uterus, particularly regarding endometrial cancer.

In women who have controlled hypertension, the choice of therapy must take into account the potential cardiovascular risks associated with hormone therapy. However, combination hormone therapy can be tailored and monitored to ensure that the benefits outweigh any possible risks. When managed appropriately, it can significantly improve quality of life during menopause.

Other options, such as estrogen therapy alone, may not be optimal for all women, especially those with specific health concerns. Antidepressants may help with mild symptoms but may not provide sufficient relief for all menopausal issues. Natural supplements can vary widely in efficacy and safety and are not always rigorously studied, so they might not offer the same level of reliable symptom relief as combination hormone therapy. Therefore, combination hormone therapy stands out as a well-supported choice in this scenario.