The risks and benefits of hormone replacement therapy

The short-term benefits of hormone replacement therapy (HRT) for the relief of acute menopausal symptoms are beyond dispute. It is equally clear that premenopausal women who have undergone surgical menopause need HRT to prevent the otherwise rapid development of coronary heart disease and osteoporosis. There is epidemiologic evidence that women who have undergone a natural menopause receive similar relief with HRT. Yet patient compliance with long-term HRT is poor. This is due to unacceptable uterine bleeding and the largely unfounded fear that HRT promotes breast cancer.