Update on the benefits and risks of hormone replacement therapy

New data are continually refining our understanding of the benefits and risks of hormone replacement therapy (HRT) in postmenopausal women. The current state of evidence reveals unequivocally that HRT increases bone mineral density, reduces the risk of osteoporotic fracture, and relieves postmenopausal symptoms and vaginal atrophy. The role of HRT for secondary prevention of coronary heart disease (CHD) has recently been. repudiated, while its role for primary prevention remains to be fully elucidated. Proven risks of HRT include endometrial cancer (but only with unopposed estrogen therapy), thromboembolism, elevations In triglyceride levels, and gallbladder disease. There is strong evidence for an association between breast cancer and use of HRT for more than 5 years. More data are needed to clarify potential protective effects against colorectal cancer and dementia and a potential association with ovarian cancer.