Hormone replacement therapy: evaluating the risks and benefits.
OBJECTIVE
To review the literature related to the benefits and risks of postmenopausal hormone replacement therapy (HRT).


METHODS
Computerized searches on MEDLINE and CINAHL.


METHODS
Articles from indexed journals in the English language related to the topics in this review and published after 1986 (except for earlier classic pieces) were evaluated.


METHODS
Data were extracted and information was organized about HRT under the following headings: indications, risks, contraindications, management of therapy, and evaluation of risks and benefits.


RESULTS
Hormone replacement therapy is used to treat symptoms of estrogen deficiency and to prevent disease. The small risk of breast cancer associated with HRT is outweighed by the beneficial effects of such therapy in preventing cardiovascular disease and osteoporosis.


CONCLUSIONS
Evidence suggests that HRT should be offered to all postmenopausal women in whom it is not contraindicated. Ideally, each woman should decide whether to receive HRT after weighing the risks and benefits. Additional research is needed on the effects of different doses, types of estrogen and progestin, and treatment duration, and on which HRT regimen offers the best risk-benefit profile.
Saint Anselm College, Manchester, NH 03102-1310.
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McKeon
D000359:Aftercare; D000075202:Contraindications; D015914:Estrogen Replacement Therapy / Q000009:adverse effects* / Q000379:methods* / Q000451:nursing; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D010353:Patient Education as Topic; D018579:Patient Selection; D012307:Risk Factors