Benefits and risks of hormone replacement therapy

Hormone replacement therapy (HRT) comprises oestrogen with or without progestogen.

Benefits—HRT is the most effective treatment for the relief of menopausal symptoms and for the primary prevention of postmenopausal osteoporosis. There are also possible benefits for coronary heart disease, colorectal cancer, and neurocognitive function, but these are yet to be established.

Risks—the main risk of HRT is perhaps a small increase in incidence of breast cancer, but this risk may be confined to women with a long exposure to certain oestrogen–progestogen combinations. There is a small increased risk...

Hormone replacement therapy (HRT) comprises oestrogen with or without progestogen.

Benefits—HRT is the most effective treatment for the relief of menopausal symptoms and for the primary prevention of postmenopausal osteoporosis. There are also possible benefits for coronary heart disease, colorectal cancer, and neurocognitive function, but these are yet to be established.

Risks—the main risk of HRT is perhaps a small increase in incidence of breast cancer, but this risk may be confined to women with a long exposure to certain oestrogen–progestogen combinations. There is a small increased risk of stroke if HRT is initiated in older women and a small increased risk of venous thromboembolism with oral therapy.

Balance of benefits and risks—given appropriately, the benefits of HRT outweigh the risks. The choice and dose of therapeutic agents should be tailored to suit the individual case, but usually the therapy used should be the one that the patient finds most acceptable. Risks and benefits should be reviewed annually, but no limit on duration of treatment need be set.