{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:29:43Z","timestamp":1790720983868,"version":"4.1.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Clinical guidance for perimenopausal hormone replacement therapy (HRT) varies across regions, creating uncertainty when clinicians need to balance safety with testing burden and cost. We conducted an evidence-based narrative review to summarize the clinical value of key indicators used in perimenopausal HRT decision-making. To gather relevant evidence, we searched PubMed, Web of Science, and Scopus for studies published from January 2014 to December 2025 using keywords related to perimenopause, HRT, biomarkers, clinical decision-making, and risk stratification. We focused on indicators from hormonal, skeletal, and cardiometabolic domains, as well as selected imaging and symptom measures. Traditional hormones such as follicle-stimulating hormone (FSH) and estradiol are useful for staging, but single measurements are limited by cyclic fluctuations. For bone health, combining bone mineral density with bone turnover markers (e.g., \u03b2-CTX and PINP) may improve the assessment of fracture risk and treatment response. For cardiometabolic safety, lipid profiles and inflammatory markers (e.g., C-reactive protein) support risk evaluation. Based on the literature, we propose a tiered evaluation framework: utilizing standard, widely available tests for routine assessment, while reserving advanced biomarkers for high-risk or unclear cases. This approach aims to support practical clinical assessment without replacing individualized clinical judgment, offering a highly cost-effective strategy tailored for resource-limited settings.<\/jats:p>","DOI":"10.4103\/njcp.njcp_879_25","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T18:00:11Z","timestamp":1777572011000},"page":"373-381","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Indicators for Perimenopausal Hormone Replacement Therapy: An Evidence-Based Narrative Review"],"prefix":"10.4103","volume":"29","author":[{"given":"Y","family":"Luo","sequence":"first","affiliation":[{"name":"Shanxi Province Key Laboratory Cultivation Base Jointly Established by the Department and City of Hormone Metabolic Diseases during Perimenopause, Datong, Shanxi Province, P.R. China"},{"name":"Clinical Research Laboratory, Datong, Shanxi Province, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Liang","sequence":"additional","affiliation":[{"name":"Shanxi Province Key Laboratory Cultivation Base Jointly Established by the Department and City of Hormone Metabolic Diseases during Perimenopause, Datong, Shanxi Province, P.R. China"},{"name":"Clinical Research Laboratory, Datong, Shanxi Province, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Gao","sequence":"additional","affiliation":[{"name":"Clinical Research Laboratory, Datong, Shanxi Province, P.R. China"},{"name":"Department of Gynecology, The First People\u2019s Hospital of Datong, Datong, Shanxi Province, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Research Laboratory, Datong, Shanxi Province, P.R. China"},{"name":"Department of Gynecology, The First People\u2019s Hospital of Datong, Datong, Shanxi Province, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Li","sequence":"additional","affiliation":[{"name":"Shanxi Province Key Laboratory Cultivation Base Jointly Established by the Department and City of Hormone Metabolic Diseases during Perimenopause, Datong, Shanxi Province, P.R. China"},{"name":"Clinical Research Laboratory, Datong, Shanxi Province, P.R. 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