Estrogen replacement therapy--boon or bane? Current status of the controversy

The three primary indications for estrogen replacement therapy in postmenopausal women are severe vasomotor symptoms (hot flashes), prevention or treatment of osteoporosis, and atrophy of the genital tract. Estrogen replacement therapy is well established as reducing the morbidity and mortality associated with osteoporosis. The increased incidence of endometrial cancer associated with estrogen use (from 1/1,000 to 4/1,000 per year) must be accepted and viewed in perspective. Many of these estrogen-related cancers are stage I lesions, with a cure rate of 95%. In addition, the risk associated with estrogen replacement therapy can be reduced by coadministration of a progestogen during the last ten days of the cycle.