What are the benefits and risks of HRT?

Hormone replacement therapy (HRT) is the most effective treatment for menopause symptoms in peri- and postmenopausal women, in particular for the vasomotor symptoms of hot flushes and sweats and symptoms relating to the atrophic changes in the urogenital tract. Over-the-counter alternative products have no better effect than placebo. About 20% of women will have moderate to severe symptoms that interfere with quality of life, and longitudinal studies have shown that significant symptoms may last up to a mean of eight years, with about 10% of women affected having symptoms for 10 years or more.

Opinions concerning the benefits and risks of HRT have varied over the past decade. This article aims to summarise the current position, as given in the most recent recommendations of the International Menopause Society.