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Women & Infants Center for Reproduction & Infertility
Hormone Replacement Therapy

Menopause          A Women's Guide to Menopause

Hormone Replacement Therapy (HRT)

In the summer of 2002, a large, federally-funded study, found that hormone replacement therapy (HRT) involving a combination of  estrogen and progestin when used by postmenopausal women for more than four years leads to a small increased risk of heart attacks, stroke, blood clots in the legs and lungs, and invasive breast cancer.

The study, conducted by the Women's Health Initiative  (WHI), found that although the risks to women’s health are slight, they outweighed the benefits. The WHI therefore stopped the estrogen and progestin arm of the study on July 9, 2002, after approximately five years (three years before its scheduled finish) and issued a recommendation that women in the study stop their study pills. The study of estrogen only is continuing.

What is hormone replacement therapy (HRT)?

HRT is a treatment that is often prescribed to postmenopausal women to help relieve symptoms that accompany menopause: hot flashes, night sweats, vaginal dryness, and sleeplessness.  HRT has also been prescribed to prevent some long-term health problems that can accompany menopause, such as cardiovascular disease and osteoporosis or bone loss.

Hormonal treatment may consist of estrogen alone, prescribed for women who have had a hysterectomy, or a combination of estrogen and progestin (a synthetic form of progesterone) for women who still have a uterus and are going through menopause.

In its study of estrogen plus progestin, the Women’s Health Initiative study investigated a popular brand name HRT called Prempro.  The hormones taken by the women in the study were 0.625 milligrams of conjugated equine estrogens daily) and 2.5 milligrams of  medroxyprogesterone acetate (daily.)

The WHI study found that HRT actually increases the risks of developing cardiovascular disease, blood clots, stroke,  and invasive breast cancer.  Some benefits of HRT continue to be supported by the study, including fewer cases of colorectal cancer and fewer bone fractures.

If you are taking HRT, what should you do?

This is a complex issue with individual risks and benefits.  Women who are taking HRT should talk with their physician about continuing or ending their use of HRT in a timely but not emergent fasion to see how these results apply to them personally, and what is the best course of action for them.

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