In relatively healthy women , combined continuous HT significantly increased the risk of venous thrombo-embolism or coronary event ( after one year 's use ) , stroke ( after three years ) , breast cancer and gallbladder disease .
Long-term oestrogen-only HT significantly increased the risk of venous thrombo-embolism , stroke and gallbladder disease ( after one to two years , three years and seven years ' use respectively ) , but did not significantly increase the risk of breast cancer .
The only statistically significant benefits of HT were a decreased incidence of fractures and ( for combined HT ) colon cancer , with long-term use .
Among women aged over 65 who were relatively healthy ( i.e. generally fit , without overt disease ) and taking continuous combined HT , there was a statistically significant increase in the incidence of dementia .
Among women with cardiovascular disease , long-term use of combined continuous HT significantly increased the risk of venous thrombo-embolism .
AUTHORS ' CONCLUSIONS HT is not indicated for the routine management of chronic disease .
We need more evidence on the safety of HT for menopausal symptom control , though short-term use appears to be relatively safe for healthy younger women
BACKGROUND Hormone therapy ( HT ) is widely used for controlling menopausal symptoms and has also been used for the management and prevention of cardiovascular disease , osteoporosis and dementia in older women .
This is an up date d version of the original Cochrane review first published in 2005 .
OBJECTIVES To assess the effect of long-term HT on mortality , cardiovascular outcomes , cancer , gallbladder disease , cognition , fractures and quality of life .
Effects of conjugated equine estrogen on risk of fractures and BMD in postmenopausal women with hysterectomy: results from the women's health initiative randomized trial.
UNLABELLED Further analyses from the Women 's Health Initiative estrogen trial shows that CEE reduced fracture risk . The fracture reduction at the hip did not differ appreciably among risk strata . These data do not support overall benefit over risk , even in women at highest risk for fracture . INTRODUCTION The Women 's Health Initiative provided evidence that conjugated equine estrogen ( CEE ) can significantly reduce fracture risk in postmenopausal women . Additional analysis of the effects of CEE on BMD and fracture are presented . MATERIAL S AND METHODS Postmenopausal women 50 - 79 years of age with hysterectomy were r and omized to  CEE 0.625 mg daily ( n = 5310 ) or placebo ( n = 5429 ) and followed for an average 7.1 years . Fracture incidence was assessed by semiannual question naire and verified by adjudication of radiology reports . BMD was measured in a subset of women ( N = 938 ) at baseline and years 1 , 3 , and 6 . A global index was used to examine whether the balance of risks and benefits differed by baseline fracture risk . RESULTS CEE reduced the risk of hip ( hazard ratio [ HR ] , 0.65 ; 95 % CI , 0.45 - 0.94 ) , clinical vertebral ( HR , 0.64 ; 95 % CI , 0.44 - 0.93 ) , wrist/lower arm ( HR , 0.58 ; 95 % CI , 0.47 - 0.72 ) , and total fracture ( HR , 0.71 ; 95 % CI , 0.64 - 0.80 ) . This effect did not differ among strata according to age , oophorectomy status , past hormone use , race/ethnicity , fall frequency , physical activity , or fracture history . Total fracture reduction was less in women at the lowest predicted fracture risk in both absolute and relative terms ( HR , 0.86 ; 95 % CI , 0.68 - 1.08 ) . CEE also provided modest but consistent positive effects on BMD . The HRs of the global index for CEE were relatively balanced across tertiles of summary fracture risk ( lowest risk : HR , 0.81 ; 95 % CI , 0.62 - 1.05 ; mid risk : HR , 1.09 ; 95 % CI , 0.92 - 1.30 ; highest risk : HR , 1.04 ; 95 % CI , 0.88 - 1.23 ; interaction , p = 0.42 ) . CONCLUSIONS CEE reduces the risk of fracture and increases BMD  in hysterectomized postmenopausal women . Even among the women with the highest risk for fractures , when considering the effects of estrogen on other important health outcomes , a summary of the burden of monitored effects does not indicate a significant net benefit
In relatively healthy women , combined continuous HT significantly increased the risk of venous thrombo-embolism or coronary event ( after one year 's use ) , stroke ( after three years ) , breast cancer and gallbladder disease .
Long-term oestrogen-only HT significantly increased the risk of venous thrombo-embolism , stroke and gallbladder disease ( after one to two years , three years and seven years ' use respectively ) , but did not significantly increase the risk of breast cancer .
The only statistically significant benefits of HT were a decreased incidence of fractures and ( for combined HT ) colon cancer , with long-term use .
Among women aged over 65 who were relatively healthy ( i.e. generally fit , without overt disease ) and taking continuous combined HT , there was a statistically significant increase in the incidence of dementia .
Among women with cardiovascular disease , long-term use of combined continuous HT significantly increased the risk of venous thrombo-embolism .
AUTHORS ' CONCLUSIONS HT is not indicated for the routine management of chronic disease .
We need more evidence on the safety of HT for menopausal symptom control , though short-term use appears to be relatively safe for healthy younger women
BACKGROUND Hormone therapy ( HT ) is widely used for controlling menopausal symptoms and has also been used for the management and prevention of cardiovascular disease , osteoporosis and dementia in older women .
This is an up date d version of the original Cochrane review first published in 2005 .
OBJECTIVES To assess the effect of long-term HT on mortality , cardiovascular outcomes , cancer , gallbladder disease , cognition , fractures and quality of life .