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Introduction
Menopausal hormone use (sometimes referred to as hormone replacement therapy or postmenopausal hormone use) usually involves treatment with either estrogen alone or a combination of estrogen with progesterone or progestin, a synthetic hormone with effects similar to those of progesterone.
The best evidence for the risks and benefits of menopausal hormone use comes from the Women's Health Initiative (WHI), a large randomized clinical trial including more than 16,000 healthy women, sponsored by the National Institutes of Health (NIH).
Results from the trial published in 2002 showed that the overall risks of estrogen plus progestin outweigh the benefits. Among the risks observed after 5.6 years of follow-up were increased risks of breast cancer, heart disease, stroke and blood clots.
On March 1, 2004, after nearly seven years of follow-up, NIH stopped the estrogen-alone arm of the trial, concluding that estrogen alone does not appear to affect (either increase or decrease) heart disease, a key question of the study. In addition, estrogen alone appears to increase the risk of stroke and decrease the risk of hip fracture. No increase in breast cancer risk was observed during the study period.
The National Cancer Institute (NCI) has prepared a fact sheet on menopausal hormone use. The National Institutes of Health (of which NCI is a part) also maintains a list of its most current information on menopausal hormone therapy.
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