Several recent large studies have provoked concern among both health professionals and the general public regarding the safety of hormone replacement therapy (HRT). This article provides a review of the current literature surrounding the risks and benefits of HRT in postmenopausal women, and how the data can be applied safely in everyday clinical practice.
HillK.The demography of menopause. Maturitas 1996; 23:113–27. doi:10.1016/0378-5122(95)00968-X
2.
Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002; 288:321–33. doi:10.1001/jama.288.3.321
3.
GradyDHerringtonDBittnerV, for the HERS Research Group. Cardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II). JAMA 2002; 288:49–57. doi:10.1001/jama.288.1.49
4.
HulleySPurbergCBarrett-ConnorE, for the HERS Research Group. Noncardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II). JAMA 2002; 288:58–66. doi:10.1001/jama.288.1.58
5.
BeralVMillion Women StudyCollaborators. Breast cancer and hormone replacement therapy in the Million Women Study. Lancet 2003; 362:419–27. doi:10.1016/S0140-6736(03)14596-5
6.
PinesASturdeeWBirkhauserMH, for the International Menopause Society. HRT in the early menopause: scientific evidence and common perceptions. Climacteric 2008; 11:267–72. doi:10.1080/13697130802226866
7.
KimNGrossCCurtisJ The impact of clinical trials on the use of hormone replacement therapy: a population-based study. J Gen Intern Med 2005; 20:1026–31. doi:10.1111/j.1525-1497.2005.0221.x
8.
RossouwJEPrenticeRLMansonJE Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA 2007; 297:1465–77. doi:10.1001/jama.297.13.1465
9.
MansonJEAllisonMARossouwJE Estrogen therapy and coronary-artery calcification. N Engl J Med 2007; 356:2591–602. doi:10.1056/NEJMoa071513
10.
GrodsteinFMansonJEStampferJ Postmenopausal hormone therapy and stroke. The role of time since menopause and age of initiation of hormone therapy. Arch Intern Med 2008; 168:861–6. doi:10.1001/archinte.168.8.861
11.
JacksonRDWactawski-WendeJLaCroizAZ Effects of conjugated equine estrogen on risk of fractures and BMD in postmenopausal women with hysterectomy: results from the Women’s Health Initiative randomized trial. J Bone Miner Res 2006; 21:817–28. doi:10.1359/jbmr.060312
12.
GambaccianiMCiaponiMGenazzaniAR.The HRT misuse and osteoporosis epidemic: a possible future scenario. Climacteric 2007; 10:273–5. doi:10.1080/13697130701511277
13.
ChlebowskiRTHendrixSLLangerRD Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women’s Health Initiative randomized trial. JAMA 2003; 289:3243–53. doi:10.1001/jama.289.24.3243
14.
StefanickMLAndersonGLMargolisKL Effects of conjugated equine estrogens on breast cancer and mammography screening in postmenopausal women with hysterectomy. JAMA 2006; 295:1647–57. doi:10.1001/jama.295.14.1647
15.
Million Women Study Collaborators. Ovarian cancer and hormone replacement therapy in the Million Women Study. Lancet 2007; 369:1703–10. doi:10.1016/S0140-6736(07)60534-0
16.
AndersonGLJuddHLKaunitzAM Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures. JAMA 2003; 290:1739–48. doi:10.1001/jama.290.13.1739
17.
CushmanMKullerLH, Prentice Estrogen plus progestin and risk of venous thrombosis. JAMA 2004; 292:1573–80. doi:10.1001/jama.292.13.1573
18.
CanonicoMOgerEPlu-BureauG Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation 2007; 115:840–5. doi:10.1161/CIRCULATIONAHA.106.642280
19.
ScarabinPYOgerEPlu-BureauG Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk. Lancet 2003; 362:428–32. doi:10.1016/S0140-6736(03)14066-4
20.
HaysJOckeneJKBrunnerRL Effects of estrogen plus progestin on health-related quality of life. N Engl J Med 2003; 348:1839–54. doi:10.1056/NEJMoa030311
21.
WeltonAJVickersMRKimJ Health related quality of life after combined hormone replacement therapy: randomised controlled trial. BMJ 2008; 337:a1190. doi:10.1136/bmj.a1190