MERIT - Menopause: Evidence on Risks and benefits for Individualized Therapies

Menopausal hormone therapy is an effective treatment for severe menopausal symptoms, affecting more than 70% of women and impacting quality of life, sleep, mood, work capacity, and overall wellbeing. Despite its effectiveness, MHT remains underused in Sweden, only 5–6% of women receive treatment today, largely due to misconceptions, outdated fears about risks, and limited access to clinicians with updated knowledge.

This large-scale, multidisciplinary project aims to fill major knowledge gaps and provide modern, individualized, and evidence-based guidance on MHT for women and healthcare providers. The project combines:

• Two national surveys exploring attitudes, preferences, and experiences of women and clinicians.
• Large national register studies of over 1 million women, examining associations between different MHT regimens and outcomes such as cancer, cardiovascular disease, and mental health.
• A multicenter double-blind randomized controlled trial comparing micronized progesterone vs. norethisterone acetate in combination with estradiol.

The goal is to support women in making informed choices, provide clinicians with clearer guidance, and contribute to updated national guidelines for safe and individualized menopausal hormone therapy.