The role of HRT: Where are we now? Clinical implications of latest HRT data

Abstract

The results of the Women's Health Initiative have highlighted some small but important risks associated with hormone replacement therapy (HRT). Interpretation of these findings by the media has generated considerable adverse publicity. This review discusses the clinical implications of recent data relating to HRT. When used appropriately for the control of menopausal symptoms or for treating or preventing osteoporosis in those at risk, the benefits generally outweigh the risks. For symptom control or bone effects, the type of HRT chosen should be that which achieves its therapeutic goal with as few adverse effects as possible. Currently, there is little rationale for the use of HRT in the prevention of cardiovascular disease. To help ensure the appropriate use of HRT, women and healthcare professionals alike require high quality, up-to-date information on menopause and its management. Notwithstanding issues relating to quality of content, the Internet is a useful source of information with much potential for education. The appropriate use of HRT also depends upon regular review of patients taking HRT and other “at risk” groups (eg, patients at risk of developing osteoporosis). This practice allows re-analysis of risk vs benefit, the balance of which will change with duration of therapy, the development of other medical problems and the publication of new information on HRT.