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 .
Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women.
CONTEXT In the Women 's Health Initiative r and omized , placebo-controlled trial of estrogen plus progestin , after a mean intervention time of 5.6 ( SD , 1.3 ) years ( range , 3.7 - 8.6 years ) and a mean follow-up of 7.9 ( SD , 1.4 ) years , breast cancer incidence was increased among women who received combined hormone therapy . Breast cancer mortality among participants in the trial has not been previously reported . OBJECTIVE To determine the effects of therapy with estrogen plus progestin on cumulative breast cancer incidence and mortality after a total mean follow-up of 11.0 ( SD , 2.7 ) years , through August 14 , 2009 . DESIGN , SETTING , AND PARTICIPANTS A total of 16,608 postmenopausal women aged 50 to 79 years with no prior hysterectomy from 40 US clinical centers were r and omly assigned to receive combined conjugated equine estrogens , 0.625 mg/d , plus medroxyprogesterone acetate , 2.5 mg/d , or placebo pill . After the original trial completion date ( March 31 , 2005 ) , reconsent was required for continued follow-up for breast cancer incidence and was obtained from 12,788 ( 83 % ) of the surviving participants . MAIN OUTCOME MEASURES Invasive breast cancer incidence and breast cancer mortality . RESULTS In intention-to-treat analyses including all r and omized participants and censoring those not consenting to additional follow-up on March 31 , 2005 , estrogen plus progestin was associated with more invasive breast cancers compared with placebo ( 385 cases [ 0.42 % per year ] vs 293 cases [ 0.34 % per year ] ; hazard ratio [ HR ] , 1.25 ; 95 % confidence interval [ CI ] , 1.07 - 1.46 ; P = .004 ) . Breast cancers in the estrogen-plus-progestin group were similar in histology and grade to breast cancers in the placebo group but were more likely to be node-positive ( 81 [ 23.7 % ] vs 43 [ 16.2 % ] , respectively ; HR , 1.78 ; 95 % CI , 1.23 - 2.58 ; P = .03 ) . There were more deaths directly attributed to breast cancer ( 25 deaths [ 0.03 % per year ] vs 12 deaths [ 0.01 % per year ] ; HR , 1.96 ; 95 % CI , 1.00 - 4.04 ; P = .049 ) as well as more deaths from all causes occurring after a breast cancer diagnosis ( 51 deaths [ 0.05 % per year ] vs 31 deaths [ 0.03 % per year ] ; HR , 1.57 ; 95 % CI , 1.01 - 2.48 ; P = .045 ) among women who received estrogen plus progestin compared with women in the placebo group . CONCLUSIONS Estrogen plus progestin was associated with greater breast cancer incidence , and the cancers are more commonly node-positive . Breast cancer mortality also appears to be increased with combined use of estrogen plus progestin . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00000611
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 .