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 .
Randomized, Double-Blind, Placebo-Controlled Study on Effects of Raloxifene and Hormone Replacement Therapy on Plasma NO Concentrations, Endothelin-1 Levels, and Endothelium-Dependent Vasodilation in Postmenopausal Women
The endothelium is thought to play an important role in the genesis of atherosclerosis , and several lines of evidence suggest that the effect of an intervention on endothelial function might predict its involvement in coronary disease progression and in the rate of cardiovascular events . Estrogen has direct effects on the blood vessel wall , indicating that vascular endothelium may play a key role in the cardiovascular protective effects of hormone replacement therapy ( HRT ) . Raloxifene relaxes coronary arteries in vitro by an estrogen receptor – dependent and NO-dependent mechanism , thus suggesting that this selective estrogen receptor modulator could also have beneficial effects on endothelial function . This study compared the effects of HRT and raloxifene on NO products , endothelin-1 plasma levels , and endothelium-dependent vasodilatation in postmenopausal women . Healthy postmenopausal women ( n=90 ) were enrolled in a double-blind , r and omized , placebo-controlled , 6-month trial . Women were r and omly assigned to receive continuous HRT ( 1 mg 17&bgr;-estradiol combined with 0.5 mg norethisterone acetate ) , raloxifene ( 60 mg/d ) , or placebo for 6 months . Flow-mediated endothelium-dependent vasodilation of the brachial artery , plasma NO concentrations , and endothelin levels were measured at baseline and after 6 months of therapy . The mean baseline level of NO breakdown products was 26.5±10.7 & mgr;mol/L and increased to 36.3±11.4 & mgr;mol/L after 6 months of treatment with raloxifene . The mean baseline plasma endothelin level was 17.3±8.9 pg/mL and decreased to 11.5±2.1 pg/mL after 6 months of treatment with the selective estrogen receptor modulator . The mean baseline ratio of NO ( breakdown products ) to endothelin was also significantly increased at the end of treatment with raloxifene . Postmenopausal women treated with HRT had similar changes in plasma nitrites/nitrates and endothelin levels as well as in the ratio of NO to endothelin . In contrast , these markers of endothelial function did not change in the placebo-treated women  . Flow-mediated endothelium-dependent vasodilation of the brachial artery was 8.3±2.1 % at baseline and increased to 12.3±2.1 % after 6 months of treatment with raloxifene . HRT also caused a significant and similar increase in flow-mediated endothelium-dependent vasodilation . No change in flow-mediated vasodilation was observed in the participants treated with placebo . We conclude that raloxifene therapy and HRT influence endothelial function and improve flow-mediated endothelium-dependent vasodilation to a comparable extent in healthy postmenopausal women at least after a 6-month treatment period . However , further investigation is warranted to enhance our underst and ing of the mechanisms of the effect of raloxifene on vascular function and to determine whether its effect on endothelial function may contribute to the reduction in cardiovascular-related morbidity and mortality
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 .