ACOG Committee Opinion No. 420: Hormone Therapy and Heart Disease

Abstract

The effect of menopausal hormone therapy on coronary heart disease has been the subject of much concern. The Heart and Estrogen/Progestin Replacement Study (HERS) and Women's Health Initiative studies found an increased risk of cardiovascular events with conjugated equine estrogen and medroxyprogesterone acetate use. However, recent evidence suggests that women in early menopause who are in good cardiovascular health are at low risk of adverse cardiovascular outcomes and as such should be considered candidates for the use of conjugated equine estrogen or conjugated equine estrogen and medroxyprogesterone acetate for relief of menopausal vasomotor symptoms. Hormone therapy use should be limited to the treatment of menopausal symptoms at the lowest effective dosage over the shortest duration possible, and continued use should be reevaluated on a periodic basis.