Overview of the efficacy of hormonal replacement therapy.

The most widely recognized reason for prescribing estrogen for menopausal women is for control of symptoms. Estrogen effectively reduces the vasomotor, somatic, and associated psychologic components of the menopausal syndrome. Recently, however, the role of estrogen in the prevention of disease, particularly osteoporosis, urogenital atrophy, and atherosclerotic cardiovascular disease, has prompted consideration of this treatment for a more long-term goat. Bone loss occurring after menopause can be prevented by the use of estrogen; this significantly reduces the morbidity and mortality of associated fractures. Atrophic changes, which can occur earlier in the menopause than previously recognized, also respond to estrogen treatment. Atherosclerotic risk profiles are improved by estrogen replacement: blood pressure is lowered, total cholesterol and low-density lipoprotein cholesterol are reduced, and high-density lipoprotein cholesterol is increased. Most studies have found that the incidence of angina or myocardial infarction is lower in estrogen users than in nonusers, and overall mortality rates from cardiovascular disease appear to be reduced as well.