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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
PubMed

Insights

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.

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