eMJA     The Medical Journal of Australia

Home | Issues | eMJA shop | Classifieds | Contact | More... | Topics | Search | Login | Buy full access   

Review

The benefits of oestrogen following menopause: why hormone replacement therapy should be offered to postmenopausal women

Barry G Wren
MJA 2009; 190 (6): 321-325
Abstract
  • Recently, two major epidemiological studies found that hormone replacement therapy (HRT) in postmenopausal women increased the risk of breast cancer. One of the studies also found that HRT increased the risk of cardiovascular disease and thrombosis. As a consequence, women were advised to cease this therapy.

  • However, detailed analysis of these studies suggests that the conclusions may be erroneous. Other studies suggest that the timing of initiation of HRT for healthy women is critical to achieving a beneficial outcome.

  • When begun within 5 years of menopause in healthy women, oestrogen-based HRT results in far greater benefits than adverse outcomes.

  • There is substantial objective evidence that the benefits of HRT include:

    • Reduced distressing symptoms of menopause.

    • Reduced risk of osteoporotic fractures, dementia and colorectal cancer.

    • Improved wellbeing, quality of life; improved vaginal epithelium, sexual enjoyment and bladder capacity.

    • Improved cardiovascular system, with reduced myocardial ischaemia and cardiovascular-related death.

    • Increased longevity.

  • The adverse effects of HRT include:

    • Oral HRT doubles the risk of thromboembolism.

    • HRT promotes growth of pre-existing breast cancer.

Home | Issues | eMJA shop | Terms of use | Classifieds | More... | Contact | Topics | Search

The Medical Journal of Australia    eMJA  

©The Medical Journal of Australia 2009 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377