Long-term hormone replacement therapy use is no longer controversial

Abstract

The continuance of hormone replacement therapy (HRT) use over a long period of time is necessary to fully achieve and maintain the beneficial effects of estrogens. Long-term HRT use has been associated with an increase of the risks that have been related to estrogens. However, the strongest epidemiological evidence available against long-term use is the increase of the risk of developing breast cancer diagnosed with increasing duration of use. Other controversial points of HRT use, such as thromboembolic events and gallbladder disease, do not seem to be related to the duration of HRT use. On the other hand, the benefits of estrogens on coronary heart disease and on all-cause mortality appears to increase with long-term use. On these basis, HRT continuance over a long period should be recommended. However, the decision to make this recommendation should be carefully evaluated taking into account the needs and risks of each individual woman.