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Hormone replacement therapy: what is the evidence today?
B Uebelhart1, D Frey, D Uebelhart
1Division of Bone Disease, Department of Geriatrics, University Hospital, 1211, Geneva 14, Switzerland. brigitte.uebelhart@hcuge.ch
Zeitschrift Fur Rheumatologie
|December 20, 2003
Summary
Long-term hormone replacement therapy (HRT) prevents fractures but increases risks for breast cancer, blood clots, and strokes. HRT is not recommended for cardiovascular prevention or cognitive health.
Area of Science:
- Reproductive Endocrinology
- Gerontology
- Cardiovascular Medicine
Background:
- Hormone replacement therapy (HRT) has been used for menopausal symptoms.
- Recent studies have re-evaluated the risks and benefits of long-term HRT.
Purpose of the Study:
- To summarize the current evidence on the long-term effects of HRT.
- To evaluate HRT's impact on fracture prevention, cardiovascular disease, cancer incidence, and cognitive function.
Main Methods:
- Review of recent scientific studies and clinical trial data.
- Analysis of HRT's effects on bone health, cardiovascular outcomes, cancer rates, and neurological functions.
Main Results:
- HRT effectively prevents fractures.
- HRT does not improve established coronary artery disease.
- HRT is associated with increased breast cancer and venous thrombosis, but decreased colorectal cancer.
- HRT increases the risk of pulmonary embolisms and strokes.
- HRT does not improve cognitive function or prevent dementia.
Conclusions:
- HRT should not be recommended for primary or secondary prevention of cardiovascular diseases.
- HRT is not beneficial for cognitive health.
- HRT remains useful for managing acute estrogen deficiency symptoms in recently menopausal patients.
- Long-term HRT is not recommended due to increased risks.