Short-term hormone replacement therapy

Short-term hormone replacement therapy (HRT) is acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women, according to a new consensus statement endorsed by 15 leading medical organizations involved in women's health.

http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Selected_Articles_from_Fertility_and_Sterility/Decade_After_WHI_Experts_Agree.pdf 

Specific recommendations in the consensus statement include the following;

• The decision to use HRT must be individualized based on specific patient factors and anticipated risks and benefits. These include quality-of-life priorities, age, time since menopause, and risk for blood clots, heart disease, stroke, and breast cancer.
• For healthy, relatively young women (younger than 59 years or within 10 years of menopause) with moderate to severe menopausal symptoms, systemic HRT is an acceptable option and is the most effective treatment.
• Low-dose vaginal estrogen is the preferred treatment for women who have only vaginal dryness or discomfort with intercourse.
• To prevent uterine cancer in women who still have a uterus, HRT should include progesterone or a similar progestogen, as well as estrogen. Women who have undergone hysterectomy can be given only estrogen.
• Estrogen-only and estrogen-progestogen HRT are associated with increased risk for stroke and of venous thromboembolism (deep venous thrombosis and pulmonary embolus), as are hormone-based contraceptives. However, the risk is rare in women aged 50 to 59 years.
• Use of continuous estrogen with progestogen therapy for at least 5 years, and possibly even for shorter duration, is associated with an increased risk for breast cancer. When HRT is discontinued, this risk decreases.