Unravelling the confusion about HRT in women

Until the late 1990s it was believed that hormone replacement therapy (HRT) was not only beneficial in treating menopausal symptoms and reducing the risk of osteoporosis but also reduced the risk of cardiovascular disease and dementia. This was first questioned by the publication in 1998 of a secondary prevention trial of HRT in coronary heart disease and then the US primary prevention Women's Health Initiative (WHI). The last also highlighted the increased risk of breast cancer with combined oestrogen- progestogen HRT. In the UK the Million Women Study published on breast and endometrial cancer risk. Both studies received much media attention leading to confusion among women and health professionals about the benefits, risks and uncertainties regarding HRT. The aim of this review is to unravel the benefits, risks and uncertainties regarding HRT. It is essential to note HRT still offers the potential for benefit to outweigh harm, providing the appropriate regimen has been instigated in terms of dose, route and combination for that particular person.