Women taking HT had a significantly decreased incidence of fracture with long-term use .
Research ers found no strong evidence that HT has a clinical ly meaningful impact on the incidence of colorectal cancer .
AUTHORS ' CONCLUSIONS : Women with intolerable menopausal symptoms may wish to weigh the benefits of symptom relief against the small absolute risk of harm arising from short-term use of low-dose HT , provided they do not have specific contraindications .
HT may be unsuitable for some women , including those at increased risk of cardiovascular disease , increased risk of thromboembolic disease ( such as those with obesity or a history of venous thrombosis ) or increased risk of some types of cancer ( such as breast cancer , in women with a uterus ) .
The risk of endometrial cancer among women with a uterus taking oestrogen-only HT is well documented .
HT is not indicated for primary or secondary prevention of cardiovascular disease or dementia , nor for prevention of deterioration of cognitive function in postmenopausal women .
Although HT is considered effective for the prevention of postmenopausal osteoporosis , it is generally recommended as an option only for women at significant risk for whom non-oestrogen therapies are unsuitable .
BACKGROUND : Hormone therapy ( HT ) is widely provided for control of menopausal symptoms and has been used for the management and prevention of cardiovascular disease , osteoporosis and  dementia in older women .
This is an up date d version of a Cochrane review first published in 2005 .
OBJECTIVES : To assess effects of long-term HT ( at least 1 year 's duration ) on mortality , cardiovascular outcomes , cancer , gallbladder disease , fracture and cognition in perimenopausal and postmenopausal women during and after cessation of treatment .
Conjugated equine oestrogen and breast cancer incidence and mortality in postmenopausal women with hysterectomy: extended follow-up of the Women's Health Initiative randomised placebo-controlled trial.
BACKGROUND By contrast with many observational studies , women in the Women 's Health Initiative ( WHI ) trial who were r and omly allocated to receive oestrogen alone had a lower incidence of invasive breast cancer than did those who received placebo . We aim ed to assess the influence of oestrogen use on longer term breast cancer incidence and mortality in extended follow-up of this cohort . METHODS Between 1993 and 1998 , the WHI enrolled 10,739 postmenopausal women from 40 US clinical centres into a r and omised , double-masked , placebo-controlled trial . Women aged 50 - 79 years who had undergone hysterectomy and had expected 3-year survival and mammography clearance were r and omly allocated by a computerised , permuted block algorithm , stratified by age group and centre , to receive oral conjugated equine oestrogen ( 0·625 mg per day ; n=5310 ) or matched placebo ( n=5429 ) . The trial intervention was terminated early on Feb 29 , 2004 , because of an adverse effect on stroke . Follow-up continued until planned termination ( March 31 , 2005 ) . Consent was sought for extended surveillance from the 9786 living participants in active follow-up , of whom 7645 agreed . Using data from this extended follow-up ( to Aug 14 , 2009 ) , we assessed long-term effects of oestrogen use on invasive breast cancer incidence , tumour characteristics , and mortality . We used Cox regression models to estimate hazard ratios ( HRs ) in the intention-to-treat population . This study is registered with Clinical Trials.gov , number NCT00000611 . FINDINGS After a median follow-up of 11·8 years ( IQR 9·1 - 12·9 ) , the use of oestrogen for a median of 5·9 years ( 2·5 - 7·3 ) was associated with lower incidence of invasive breast cancer ( 151 cases , 0·27 % per year ) compared with placebo ( 199 cases , 0·35 % per year ; HR 0·77 , 95 % CI 0·62 - 0·95 ; p=0·02 ) with no difference ( p=0·76 ) between intervention phase ( 0·79 , 0·61 - 1·02 ) and post-intervention phase effects ( 0·75 , 0·51 - 1·09 ) . In subgroup analyses , we noted breast cancer risk reduction  with oestrogen use was concentrated in women without benign breast disease ( p=0·01 ) or a family history of breast cancer ( p=0·02 ) . In the oestrogen group , fewer women died from breast cancer ( six deaths , 0·009 % per year ) compared with controls ( 16 deaths , 0·024 % per year ; HR 0·37 , 95 % CI 0·13 - 0·91 ; p=0·03 ) . Fewer women in the oestrogen group died from any cause after a breast cancer diagnosis ( 30 deaths , 0·046 % per year ) than did controls ( 50 deaths , 0·076 % ; HR 0·62 , 95 % CI 0·39 - 0·97 ; p=0·04 ) . INTERPRETATION Our findings provide reassurance for women with hysterectomy seeking relief of climacteric symptoms in terms of the effects of oestrogen use for about 5 years on breast cancer incidence and mortality . However , our data do not support use of oestrogen for breast cancer risk reduction because any noted benefit probably does not apply to population s at increased risk of such cancer . FUNDING US National Heart , Lung , and Blood Institute ; Wyeth
Women taking HT had a significantly decreased incidence of fracture with long-term use .
Research ers found no strong evidence that HT has a clinical ly meaningful impact on the incidence of colorectal cancer .
AUTHORS ' CONCLUSIONS : Women with intolerable menopausal symptoms may wish to weigh the benefits of symptom relief against the small absolute risk of harm arising from short-term use of low-dose HT , provided they do not have specific contraindications .
HT may be unsuitable for some women , including those at increased risk of cardiovascular disease , increased risk of thromboembolic disease ( such as those with obesity or a history of venous thrombosis ) or increased risk of some types of cancer ( such as breast cancer , in women with a uterus ) .
The risk of endometrial cancer among women with a uterus taking oestrogen-only HT is well documented .
HT is not indicated for primary or secondary prevention of cardiovascular disease or dementia , nor for prevention of deterioration of cognitive function in postmenopausal women .
Although HT is considered effective for the prevention of postmenopausal osteoporosis , it is generally recommended as an option only for women at significant risk for whom non-oestrogen therapies are unsuitable .
BACKGROUND : Hormone therapy ( HT ) is widely provided for control of menopausal symptoms and has been used for the management and prevention of cardiovascular disease , osteoporosis and  dementia in older women .
This is an up date d version of a Cochrane review first published in 2005 .
OBJECTIVES : To assess effects of long-term HT ( at least 1 year 's duration ) on mortality , cardiovascular outcomes , cancer , gallbladder disease , fracture and cognition in perimenopausal and postmenopausal women during and after cessation of treatment .