Estrogens, menopause, and coronary artery disease.

The incidence of cardiovascular disease increases after menopause as women age. Estrogen-replacement therapy has been found to reduce cardiovascular risk by about 50% in over 30 observational studies. Part of the beneficial effect appears to be due to a reduction of LDL cholesterol and an increase in HDL cholesterol. Another important mechanism is related to the effect of estrogen on endothelial function. In making a decision to use estrogen-replacement therapy, the benefits must be weighed against the risks of endometrial and breast cancer.