Hormone replacement therapy: where to now?

Copyright © 2003 Australian Prescriber Reproduced with permission from Australian Prescriber The document attached has been archived with permission from the publisher/copyright holder.The Women's Health Initiative Study was stopped because of safety concerns about hormone replacement therapy with oestrogen and progestogen. There was an increase in breast cancer, however this was not greater than the increase reported in observational studies. Although there was an increase in vascular events, many of the women in the study had pre-existing risk factors for cardiovascular disease. No long-term trials of combined hormone replacement therapy are continuing, so the balance between benefit and harm will remain uncertain. Hormone replacement therapy can still be prescribed for menopausal symptoms and for osteoporosis prevention, but the need for continued use should be reviewed annually.Alastair H. MacLenna