Menopause: advanced management strategies.

Estrogen replacement therapy may offer significant benefits to nearly all postmenopausal women, especially those for whom the menopause occurred at an early age. Women at high risk for atherosclerosis, or who already have cardiovascular disease, may particularly benefit from estrogen use. The increased risk for endometrial and breast cancer seen with estrogen replacement therapy is low in comparison with its protective effect against cardiovascular disease. For women who cannot or choose not to take estrogens, etidronate may be of value in preventing osteoporotic fractures. For women many years beyond menopause who consume low-calcium diets, calcium supplementation should be recommended.