{
  "abstract": "Menopause care now spans established hormone therapy, mechanism-based non-hormonal drugs, behavioural interventions, and emerging microbiome- and biomarker-guided approaches. This state-of-the-art narrative review evaluated which dimensions of personalisation are clinically actionable and which remain hypotheses of precision medicine. A structured PubMed/MEDLINE search (January 2020–July 2026), updated to August 2026 and supplemented by landmark studies, current guidelines, and regulatory sources, was synthesized using a four-tier clinical-actionability framework (A, established; B, evidence-supported off-label; C, emerging; D, experimental). Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms and prevents bone loss during use; the 2025–2026 FDA labelling revisions altered risk communication rather than the underlying evidence, and professional responses diverged. Fezolinetant and elinzanetant provide mechanism-based non-hormonal options, while SSRIs/SNRIs, gabapentin, cognitive behavioural therapy (CBT), CBT for insomnia, and clinical hypnosis remain evidence-supported. Exercise, yoga, acupuncture, soy, and equol are not guideline-recommended for reducing vasomotor symptom frequency despite benefits in other domains. Gut and genitourinary microbiome findings should not be conflated: pooled evidence identifies no consistent postmenopausal gut signature, whereas vaginal Lactobacillus depletion is more reproducible but does not reliably predict symptom resolution. Evidence-based personalisation therefore remains principally clinical; microbiome sequencing, equol testing, and multi-omic treatment selection require prospective test-guided validation.",
  "abstract_shown": true,
  "affiliations": [
    "2nd Department of Obstetrics and Gynecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania",
    "Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania",
    "Department of Pharmacognosy, Faculty of Pharmacy, Victor Babeș University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square, No. 2, 300041 Timișoara, Romania",
    "Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Cristian Ioan Iuhas"
    },
    {
      "affs": [
        1
      ],
      "name": "Mădălina-Manuela Marinescu",
      "orcid": "0009-0009-5113-474X"
    },
    {
      "affs": [
        2
      ],
      "name": "Corina Danciu",
      "orcid": "0000-0001-5999-1214"
    },
    {
      "affs": [
        0
      ],
      "name": "Cristina Mihaela Ormindean",
      "orcid": "0009-0002-0726-8993"
    },
    {
      "affs": [
        0
      ],
      "name": "Răzvan Ciortea"
    },
    {
      "affs": [
        0
      ],
      "name": "Andrei Malutan",
      "orcid": "0000-0001-8745-9348"
    },
    {
      "affs": [
        0
      ],
      "name": "Dan Mihu"
    },
    {
      "affs": [
        1
      ],
      "name": "Zorița Diaconeasa",
      "orcid": "0000-0002-5325-3859"
    },
    {
      "affs": [
        3
      ],
      "name": "Liora Colobatiu",
      "orcid": "0000-0003-1577-4861"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/99bvk7nc1p3q2.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218674",
  "fulltext_url": null,
  "id": "99bvk7nc1p3q2",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8674",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/99bvk7nc1p3q2.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T00:21:41Z",
      "native_id": "10.3390/jcm15218674",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8674"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "From Established Care to Precision Menopause Medicine: A Clinical-Actionability Framework for Contemporary Menopause Management",
  "title_text": "From Established Care to Precision Menopause Medicine: A Clinical-Actionability Framework for Contemporary Menopause Management",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T00:21:41Z",
  "url": "https://research.draconitic.com/paper/99bvk7nc1p3q2",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}