Hormone Replacement Therapy (HRT)

The decrease in estrogen levels in women going through menopause has interested doctors and patients for many years. Synthetic estrogen was developed in the 1920's, and by the mid-1930's it was being used to relieve menopausal symptoms. In the mid-1960's, the book Feminine Forever touted the use of synthetic estrogen as a way to maintain youth and femininity. This book became a hit in the lay press and greatly increased the demand for hormone replacement therapy (HRT). HRT use decreased sharply when the connection between use of synthetic estrogen and elevated risk of endometrial cancer was recognized in the 1970's. Use of HRT has slowly gone up since the 1980's, when long-term research established the protective effects of HRT against osteoporosis and possibly heart disease. Improved treatment schedules and delivery systems have increased HRT use in the U.S. To minimize the risk of endometrial cancer, physicians are much more likely to give lower doses of estrogen and to combine it with progesterone for women whose uteruses are intact. Furthermore, many different formulations and dosing schedules now permit physicians to better tailor HRT to each patient. Although we know much more about HRT today, controversy still surrounds its risks and benefits. Those who caution against using HRT use often cite the increased risk of endometrial and breast cancer associated with using estrogen, especially for extended lengths of time, and its common side effects such as breast tenderness, nausea, unpredictable bleeding, bloating, and mood fluctuations. Those who advocate using HRT frequently point out that HRT appears not only to alleviate menopausal symptoms, but also to reduce the risk of osteoporosis, and possibly heart disease and Alzheimer'sdisease, all of which could have much greater impact than cancers on the health of postmenopausal women. Until we have more definitive information about HRT's effects on diseases, each woman must, with the help of her physician, weigh the risks and benefits of use. Whether or not a woman uses HRT depends on many factors: how she perceives the risks and benefits of HRT vs. the risks and potential harm of menopausal symptoms and various diseases affected by HRT; the information she obtains from her physician about HRT; and her access to health care.

Results from a 2003 European study linked HRT to the development of asthma in women.

In February 2004, the Food and Drug Administration requested that manufacturers update labeling for hormone therapy products (estrogen and combination estrogen and progestin products) for use by postmenopausal women with data from WHIMS-The Women's Health Initiative Memory Study. WHIMS reported an increased risk of dementia in women 65 and older and showed that estrogen with progestin (Prempro) failed to prevent mild cognitive impairment (memory loss). (WHIMS is a substudy of the Women's Health Initiative (WHI) conducted by the National Institutes of Health.)

Brett, KM, Chong Y.
Hormone Replacement Therapy:
Knowledge and Use in the United States.
Hyattsville, Maryland: National Center

for Health Statistics. 2001.

View sub-topics at right to learn more about some specific drugs used in HRT and some of the drugs' more serious adverse side effects.

See Also¶

1. Prescription & Over-the-Counter Drugs: Overview
2. Estrogen
3. Premarin
4. Prempro / Premphase
5. Progestin: Overview
6. Alzheimer's Disease
7. Asthma: Overview
8. Balance Problems: Overview
9. Blood Clots
10. Breast Cancer
11. Cancer
12. Headaches
13. Hearing Loss
14. Heart Problems
15. Memory Loss
16. Stroke