Hormone therapy--weighing up the evidence.
BACKGROUND
Hormone therapy (HT) use is well established for menopausal symptom relief, but its use is not currently considered justified for the prevention of disease.


OBJECTIVE
This article reviews the recent literature on the risks and benefits of HT in postmenopausal women.


CONCLUSIONS
Menopausal symptoms are severe in around 20% of Australian women and HT effectively relieves these symptoms. Controversy still surrounds the risk profile of HT in women at the time of the menopausal transition, although risks are likely to be small. Recent literature has demonstrated that the role of HT in disease prevention is limited, based primarily on the lack of preventive benefits rather than on the small but present adverse effects of HT use. Historically, the HT literature holds many salient lessons for clinicians. These include the shortcomings of animal data, observational human data, and human trials focussing on intermediate end-points in guiding clinical practice. The HT story also reinforces the principle that health prevention strategies in low risk primary prevention settings should be lifestyle based. Pharmacological therapy, with its inherent risks, even if small, should be reserved for high risk settings.
Teede
Helena J
HJ
Department of Medicine, Monash University, Victoria.
D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003704:Dementia / Q000453:epidemiology; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008593:Menopause / Q000187:drug effects; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D013927:Thrombosis / Q000453:epidemiology