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 .
Breast Cancer After Use of Estrogen Plus Progestin and Estrogen Alone: Analyses of Data From 2 Women's Health Initiative Randomized Clinical Trials.
IMPORTANCE The use of menopausal hormone therapy ( HT ) continues in clinical practice , but reports are conflicting concerning the longer-term breast cancer effects of relatively short-term use . OBJECTIVE To report the longer-term influence of menopausal HT on breast cancer incidence in the 2 Women 's Health Initiative ( WHI ) r and omized clinical trials . DESIGN , SETTING , AND PARTICIPANTS A total of 27,347 postmenopausal women aged 50 to 79 years were enrolled at 40 US centers from 1993 to 1998 and followed up for a median of 13 years through September 2010 . INTERVENTIONS A total of 16,608 women with a uterus were r and omized to conjugated equine estrogens ( 0.625 mg/d [ estrogen ] ) plus medroxyprogesterone acetate ( 2.5 mg/d [ progestin ] ) ( E + P ) or placebo with a median intervention duration of 5.6 years , and 10,739 women with prior hysterectomy were r and omized to conjugated equine estrogens alone ( 0.625 mg/d ) or placebo with a median intervention duration of 7.2 years . MAIN OUTCOMES AND MEASURES Time-specific invasive breast cancer incidence rates and exploratory analyses of breast cancer characteristics by intervention and postintervention phases in the 2 HT trials . RESULTS In the E + P trial , hazard ratios ( HRs ) for the influence of  combined HT  on breast cancer were lower than 1 for 2 years ( HR , 0.71 ; 95 % CI , 0.47 - 1.08 ) and steadily increased throughout intervention , becoming significantly increased for the entire intervention phase ( HR , 1.24 ; 95 % CI , 1.01 - 1.53 ) . In the early postintervention phase ( within 2.75 years from intervention ) , there was a sharp decrease in breast cancer incidence in the combined HT group , though the HR remained higher than 1 ( HR , 1.23 ; 95 % CI , 0.90 - 1.70 ) . During the late postintervention phase ( requiring patient re-consent ) , the HR for breast cancer risk remained higher than 1 through 5.5 years ( median ) of additional follow-up ( HR , 1.37 ; 95 % CI , 1.06 - 1.77 ) . In the estrogen alone trial , the HR for invasive breast cancer risk was lower than 1 throughout the intervention phase ( HR , 0.79 ; 95 % CI , 0.61 - 1.02 ) and remained lower than 1 in the early postintervention phase ( HR , 0.55 ; 95 % CI , 0.34 - 0.89 ) , but risk reduction was not observed during the late postintervention follow-up ( HR , 1.17 ; 95 % CI , 0.73 - 1.87 ) . Characteristics of breast cancers diagnosed during early and late postintervention phases differed in both trials . CONCLUSIONS AND RELEVANCE In the E + P trial , the higher breast cancer risk seen during intervention was followed by a substantial drop in risk in the early postintervention phase , but a higher breast cancer risk remained during the late postintervention follow-up . In the estrogen alone trial , the lower breast cancer risk seen during intervention was sustained in the early postintervention phase but was not evident during the late postintervention follow-up
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 .