Risks and benefits of postmenopausal exogenous estrogen.

Cyclically administered estrogen helps prevent and treat vasomotor symptoms and atrophic changes in the genitourinary tracts of postmenopausal women. Administering exogenous estrogen may also help prevent postmenopausal bone loss and help treat severe postmenopausal osteoporosis. Although recent studies have indicated an association between estrogen replacement therapy and endometrial carcinoma, a true cause-and-effect relationship has not been established. Thus, estrogen replacement therapy should be administered carefully, considering the risk/benefit ration for each individual, and should use the smallest dose necessary to achieve the desired effect. If irregular bleeding occurs before or during estrogen administration, a complete gynecologic examination (including a histologic examination of the endometrium) is mandatory.