If estrogen-containing vaginal creams and rings are used, the amount of estrogen that enters the blood stream depends on the type of hormone and the dose. Generally, vaginal administration of hormones will result in lower levels of circulating hormones compared to an equivalent oral dose. Most women will eventually need to make decisions about whether to take HRT and, if so, for how long. Although hormone replacement therapy can have beneficial effects, there are several health concerns associated with it, and many women may not feel that HRT is a good choice for them. There are several non-hormonal measures that may prevent osteoporosis and cardiovascular disease.
Local therapy is available for vaginal dryness and urinary bladder conditions.
The risk-benefit ratio of HRT is still being debated. Several studies are under way to help women make a more educated and informed choice about whether HRT is right for them. One component of the study is a randomized trial examining the effect of ERT and estrogens combined with progestins on the prevention of heart disease and osteoporosis. Increases in breast cancer risk will also be assessed. Other parts of the study will evaluate the effect of a diet low in fats and high in fruits, vegetables, and grains on the prevention of breast cancer, colorectal cancer, and heart disease as well as the effect of calcium and vitamin D supplements on the prevention of osteoporosis-related fractures.