Current perspectives on benefits and risks of hormone replacement therapy

Hormone replacement therapy with estrogen alone or with added progestin rel ieves menopausal symptoms and physical changes associated with depleted end ogenous estrogen levels. Estrogen replacement has also demonstrated a clear benefit in the prevention of osteoporosis. Hormone replacement therapy wit h added progestin maintains spinal bone density, protects against postmenop ausal hip fractures, and provides these benefits even when therapy is start ed after age 60. More recently, additional benefits have emerged. Current e strogen and hormone replacement therapy users have a 34% reduction in the r isk of colorectal cancer and a 20%. to 60% reduction in the risk of Alzheim er's disease. Until recently, the body of evidence indicated that hormone r eplacement therapy with estrogen only reduced cardiovascular disease risk b y 40% to 50% in healthy patients; whether the findings of 3 ongoing trials will change this conclusion is pending availability of the final results. T he many benefits of estrogen and hormone replacement therapy must be weighe d against a slight increase in the risk of breast cancer diagnosis with use for 5 or more years, but which disappears following cessation of therapy. Overall, estrogen and hormone replacement therapy improves the quality of l ife and increases life expectancy for most menopausal women.