Introduction: Menopause, a natural biological process, introduces a range of symptoms affecting women's quality of life. Hormone Replacement Therapy (HRT) is a widely used intervention for symptom relief, but concerns about efficacy and safety persist. This study aims to comprehensively evaluate the effectiveness of HRT in peri-menopausal and postmenopausal women, addressing the need for evidence-based guidance in clinical decision-making.

Methodology: A randomized controlled trial (RCT) design was employed; involving 90 women aged 45 to 60 with moderate to severe menopausal symptoms. Participants were randomly assigned to either the treatment (HRT) or control (placebo) group. The study, conducted in a Karachi gynecology clinic, included regular follow-ups over a 12-week period. Validated measures, such as the Menopause-Specific Quality of Life (MENQOL) questionnaire, were used to assess symptom severity and quality of life. Adherence was closely monitored through medication logs and pill counts.

Results: Baseline characteristics were comparable between the treatment and control groups, ensuring the effectiveness of randomization. The treatment group exhibited a significant reduction in menopausal symptom severity at weeks 4, 8, and 12 compared to the control group (p < 0.05). Adverse effects in the treatment group were minimal, with a slight increase at week 8, well-tolerated and significantly lower than the control group at weeks 8 and 12 (p < 0.05). Quality of life improvements were substantial in the treatment group at week 12, surpassing the control group (p < 0.05).

Conclusion: This study provides compelling evidence supporting the efficacy of Hormone Replacement Therapy in relieving menopausal symptoms with a favorable safety profile. The findings contribute to the ongoing discourse surrounding HRT, emphasizing its role as a viable therapeutic option for women experiencing moderate to severe menopausal symptoms. Limitations, including a relatively small sample size and a 12-week duration, should be considered in future research.