STUDIES

The hormone replacement therapy (HRT) portion of a large set of clinical trials was ended 3 years early because of a small but unacceptable increase in the rate of breast cancer among the women taking the combination of estrogen 0.625 mg plus progestin 2.5 mg daily for longer than 4 years. The study also showed an increase in heart attack, stroke, and blood clots in the lungs (pulmonary embolism) and legs (deep venous thrombosis).

The study did not measure the effect of estrogen when used alone or when used in different doses or by alternative methods of delivery, such as the transdermal patch. It also did not address the short-term risks and benefits of estrogen/progestin when used to treat symptoms of menopause, such as hot flashes and vaginal dryness. A study of the effects of estrogen when used without progestin is ongoing.

This study was released since the topics Menopause and Osteoporosis were updated, and women should consider this new evidence while reading these topics.

Approximately 38% of postmenopausal women in the United States use some form of hormone replacement therapy. Treatment with HRT is approved by the U.S. Food and Drug Administration for treatment of menopausal symptoms, such as hot flashes and vaginal dryness, and prevention of osteoporosis. However, many women take HRT hoping to decrease their risk for other chronic diseases, such as coronary artery disease and stroke.

If you are taking combined estrogen/progestin therapy, the American College of Obstetricians and Gynecologists advises you to discuss your individual situation with your health professional. Your decision about hormone use should take into account why you are taking hormones, how long you have been taking them, and your risk for specific conditions that may benefit or be made worse by hormone use.