Twenty years after the early termination of a randomized clinical trial, the Women's Health Initiative (WHI), multiple unanswered questions hamper optimal clinical practice in menopausal medicine. The current treatment with hormone therapy (HT) remains inadequate and has important limitations and adverse effects.

Should we fully replicate a functional ovary, which is not only estrogen and progesterone, or should we maintain the everlasting scheme? How can we deal with the problems of decreased libido, emotional instability, and physical strength in menopause? Should we keep the oral therapy with synthetic hormones, or should we prescribe only the transdermal regimen with natural hormones? How can we achieve optimal quality of life post-menopause, if we still prescribe a fixed combination of estrogen and progesterone with no possibility for individualization of the therapy? How can we solve the widespread problem of urogenital atrophy in breast cancer survivors? Why is estrogen beneficial in the atherosclerosis process when added during the first ten years after menopause, and harmful at a later age? How can we achieve a holistic approach to menopausal problems and make women satisfied at the same time? Studies have failed to prove custom-compounded hormone therapy (CCHT) as superior to conventional HT, however, special circumstances for using CCHT may still exist. Could Alzheimer’s dementia be postponed in postmenopausal women taking HT or not? Is there any association between ER α and ER β gene polymorphisms, osteoporosis susceptibility, and bone mineral density (BMD) in postmenopausal women? Should we use HT as the first-line therapy to prevent bone loss and osteoporotic fractures in all early postmenopausal women or only in patients with menopausal symptoms? Is mammographic density the same in women taking oral or transdermal HT? What should be the position of herbal medicine and other alternatives in the treatment of postmenopausal women? These dilemmas are only some of the many, which are still open in the menopause-related medical world.

This Special Issue aims to provide up-to-date answers to some of the burning clinical controversies for all practicing clinicians who, in any fashion, deal with the problems of menopausal medicine.

Potential topics include but are not limited to the following:

• Hormone therapy (HT) as a gold standard for alleviating menopausal symptoms – current concepts and regimen
• Post-menopausal osteoporosis – the place of HT in prevention and treating
• Cardiovascular disease in post-menopause – what should be done to prevent the progression?
• Alternatives to HT
• Current treatment possibilities to prevent urogenital atrophy in menopause
• Breast cancer and HT – which regimen should be taken to prevent breast cancer in HT users?
• Alzheimer dementia (AD) – could an early start of HT postpone the onset of AD?
• Custom-compounded HT – why and when to use or not?