Current concepts in estrogen replacement therapy in the menopause.

OBJECTIVE

To provide a review of the risks and benefits of hormonal replacement therapy in the menopause, including new therapeutic regimens and modes of delivery.

DESIGN

A review of the literature to identify published studies was accomplished using a computerized bibliographical search (Medline).

RESULTS

Replacement therapy is effective in treating symptoms of estrogen deficiency and in lowering the risk of osteoporosis and cardiovascular disease. The daily administration of an estrogen and progestin eliminates the withdrawal bleed and increases patient compliance. This continuous form of therapy also consistently suppresses the endometrium, decreasing the risk of hyperplasia. More studies investigating the effect of continuous therapy on the lipid profile and cardiovascular disease are needed.

CONCLUSIONS

New therapeutic regimens and modes of delivery decrease risk and increase patient acceptance of hormonal replacement therapy.