Current concepts in estrogen replacement therapy in the menopause.
OBJECTIVE
To provide a review of the risks and benefits of hormonal replacement therapy in the menopause, including new therapeutic regimens and modes of delivery.


METHODS
A review of the literature to identify published studies was accomplished using a computerized bibliographical search (Medline).


RESULTS
Replacement therapy is effective in treating symptoms of estrogen deficiency and in lowering the risk of osteoporosis and cardiovascular disease. The daily administration of an estrogen and progestin eliminates the withdrawal bleed and increases patient compliance. This continuous form of therapy also consistently suppresses the endometrium, decreasing the risk of hyperplasia. More studies investigating the effect of continuous therapy on the lipid profile and cardiovascular disease are needed.


CONCLUSIONS
New therapeutic regimens and modes of delivery decrease risk and increase patient acceptance of hormonal replacement therapy.
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Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York.
Kelly
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Jewelewicz
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D001943:Breast Neoplasms / Q000139:chemically induced; D002318:Cardiovascular Diseases / Q000209:etiology; D016889:Endometrial Neoplasms / Q000139:chemically induced; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000639:trends; D005260:Female; D006801:Humans; D008593:Menopause; D010349:Patient Compliance; D012307:Risk Factors