Update on hormone replacement therapy

The well-recognized benefits of hormone replacement therapy include relief of vasomotor symptoms, alleviation of psychogenic manifestations, prevention of atrophic vaginitis, prevention and treatment of osteoporosis, and prevention of cardiovascular disease. Risks can be minimized by proper evaluation and appropriate hormone replacement. When an adequate dosage of estrogen is given, the added progestogen does not adversely affect lipid levels. When progestogens are added to estrogen replacement therapy, the incidence of endometrial cancer is lower in postmenopausal women receiving this form of therapy than in untreated postmenopausal women. Although the risk of breast cancer is a matter of controversy, it does not seem to increase with estrogen therapy; the addition of progestogen may decrease the risk for some women. The prognosis for breast cancer is improved in women receiving hormone replacement therapy.