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 .
Colorectal Cancer in Relation to Postmenopausal Estrogen and Estrogen Plus Progestin in the Women's Health Initiative Clinical Trial and Observational Study
Background : Colorectal cancer incidence was reduced among women assigned to active treatment in the Women 's Health Initiative ( WHI ) estrogen plus progestin-r and omized trial , but the interpretation was obscured by an associated later stage of diagnosis . In contrast , the estrogen-alone trial showed no incidence reduction or differential stage at diagnosis . Here , data from the WHI observational study are considered , in conjunction with colorectal cancer mortality data from the hormone therapy trials , in an attempt to clarify postmenopausal hormone therapy effects . Participants and Methods : Postmenopausal women ages 50 to 79 years at WHI enrollment .  Estrogen-alone  analyses include 21,552 and 10,739 women who were posthysterectomy from the observational study and clinical trial , respectively .  Estrogen plus progestin analyses include 32,084 and 16,608 observational study and clinical trial women with uterus . Colorectal cancers were verified by central medical and pathology report review . Results : Hazard ratios ( 95 % confidence intervals ) from the WHI observational study were 0.80 ( 0.53 - 1.20 ) for estrogen and 1.15 ( 0.74 - 1.79 ) for estrogen plus progestin , with , respectively , 168 and 175 women diagnosed with colorectal cancer . Delayed diagnosis with estrogen plus progestin is not evident in the observational study . No protective effect on colorectal cancer mortality in the estrogen plus progestin trial is seen over an 8-year intervention and follow-up period . Conclusion : Hazard ratio patterns in the WHI clinical trial and observational study do not provide strong evidence of a clinical ly important colorectal cancer benefit with either estrogen-alone or estrogen plus progestin over 7 to 8 years of treatment and follow-up . ( Cancer Epidemiol Biomarkers Prev 2009;18(5):1531–7
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 .