EXTENDED HORMONE REPLACEMENT - WHO SHOULD GET IT, AND FOR HOW LONG

Hormone replacement therapy (HRT) after menopause may prevent cardiovascular disease and osteoporosis, chronic diseases that become increasingly important with age. For cardiovascular disease, this protection may be greatest in women with more risk factors, including age. Data suggest that HRT may mitigate bone loss in women 15 years or more past menopause, but reports are inconclusive regarding how HRT initiated after substantial bone is lost affects fracture incidence. The most troubling question is the possible association between HRT and breast cancer. Both clinician and patient must be aware of the potential for hormone-related symptoms following the initiation of HRT. Most symptoms fade in the first few months, but older women may be less willing to accept these problems unless they are provided a clear rationale for therapy.