Aspects of hormone replacement therapy in the post-menopause

A review of the literature indicates that hormone replacement therapy (HRT) in post-menopausal women not only reduces the frequency of hot flushes and sweating episodes but also has a protective effect as regards the post-menopausal osteoporotic process. However, it has not yet proved possible to arrive at any conclusions concerning the overall effect of HRT on either ischaemic heart disease and other cardiovascular problems or the risk of developing malignant neoplastic disease. Nevertheless, there is evidence that oestrogen replacement in combination with a progestogen will reduce the risk of endometrial and breast cancer. There is a clear need for additional knowledge and it would therefore seem ethically appropriate to carry out an intervention study in order to determine whether women in general or specific groups in particular would benefit from long-term HRT. Such a study would seem especially urgent, since fractures of the neck of the femur and other osteoporotic manifestations are likely to be a major problem among women in the future.