Overview of estrogen replacement therapy: a historical perspective

In the last 30 years, we have made enormous advances in understanding how estrogen works in multiple physiologic systems and how much it affects the health of aging women. We have also made major improvements in how we prescribe estrogen. As clinicians, we are obliged to provide our patients with acceptable, tolerable, safe therapy which can be continued long enough to provide clinically significant health benefits. Determining optimal long-term hormone replacement therapy is therefore the challenge for the 21st century.