Hormone replacement therapy: the debate should continue

Recent reports attributing a significant increased risk of breast cancer development, cardiac events, and Alzheimer's disease to the administration of estrogen-progestin hormone replacement therapy (HRT) require critical review, not blind acceptance. An appreciation of the numbers used to generate these conclusions, the abundance and strength of the studies that do not support them, the small size of the effect reported, even if arguably valid, and the persisting reported benefit of HRT on longevity should alert clinicians to the risks of accepting these studies as guidelines for patient management. The additional report from this same group that HRT has no effect on health-related quality of life deserves a good laugh, not serious consideration.