HRT relatively safe for healthy postmenopausal women

Short-term hormone replacement therapy (HRT) is a relatively safe treatment for healthy, recently postmenopausal women, according to a new consensus statement.

The new statement was endorsed by the North American Menopause Society, the American Society for Reproductive Medicine, the Endocrine Society, the American Academy of Family Physicians, and several other organizations. The American College of Obstetricians and Gynecologist did not endorse the statement, however.

The primary consensus is that systemic HRT is the most effective treatment for healthy women who are younger than aged 59 years or within 10 years of menopause with moderate to severe menopausal symptoms. Low-dose vaginal estrogen is the preferred treatment for women who have only vaginal dryness or discomfort with intercourse.

The organizations warned that estrogen-only and estrogen-progestogen HRT are associated with increased risk for stroke and venous thromboembolism, as are hormone-based contraceptives. The risk is rare, however, in women who are aged 50 to 59 years, they added.

In addition, the use of continuous estrogen with progestogen therapy for at least 5 years-and possibly even shorter duration-is associated with an increased risk of breast cancer. When HRT is discontinued, the risk decreases, according to the statement.