HRT involves taking a dose of estrogen, with or without progesterone, daily. Its purpose is to restore a premenopausal condition to certain organs. HRT has long been promoted for its effectiveness in diminishing such possible effects of menopause as hot flashes and for its conduciveness to the prevention of postmeno-pausal heart disease and osteoporosis. Yet fears that HRT has serious side effects often subdue, and sometimes extinguish, enthusiastic approval of it. Findings from recent surveys suggest that women in the United States tend to get descriptions of HRT and its effects primarily from the media and from their friends.
Most women experience few or none of the possible adverse effects of menopause.
In some women, however, the decrease in concentrations of estrogen and progesterone triggers a slew of complaints. These may include depression, hot flashes, urinary incontinence, and vaginal dryness. The hormonal decreases are also associated with decreases in bone mass, which can lead to osteoporosis. Although hormone replacement therapy has a long history of safety and efficacy, only about 25 percent of menopausal women in the U.S. undergo it. Increases in the risk of endometrial cancer due to estrogen replacement are thus apparently prevented.