HRT and its impact on the menopause, osteoporosis and breast cancer.

Hormone replacement therapy (HRT) is a widely used treatment for vasomotor symptoms of the menopause. In this respect, there is a wealth of randomised evidence that it is an effective and cost-effective treatment, achieving substantial quality of life gains for relatively low cost. On the other hand, potentially major health benefits lie in the prevention of chronic diseases such as osteoporosis and cardiovascular disease. Observational data strongly support the role in HRT's ability to prevent fractures; however, there is a suggestion that this antifracture benefit is only realised if treatment is taken soon after the menopause and is soon lost after cessation of treatment. HRT also increases the risk of breast cancer, which may negate much of its health benefit.