What is hormone replacement therapy? 

Hormone replacement therapy (HRT) was  a type  of treatment where the body is given hormones to prevent or treat certain medical conditions (such  as treating symptoms of menopause in women and preventing osteoporosis).

The hormones used in HRT are synthetic hormones, which means they are created in a laboratory (rather than by the body), but they act like natural hormones once inside the body. 

In the past, doctors prescribed  HRT because they hoped it could help guard against certain diseases as well as treat the symptoms  of menopause. The diseases doctors hoped HRT could help prevent included osteoporosis,  heart disease and cancer. Information from studies on HRT suggests that for many women, the risks  of using HRT may outweigh  the benefits and thus is not recommended. For other women,  benefits may outweigh the risks. This is why it is important  to talk to your doctor about HRT. 

What is the Women's Health Initiative? 

The Women's Health Initiative (WHI) is  a set  of studies conducted by the National Institutes of Health, a division of the U.S. Department of Health and Human Services. Through these studies, WHI researchers gathered information about the health of women who have gone through menopause. In the  HRT trial, researchers were studying the effects of HRT on the health of postmenopausal women. Researchers were trying  to determine whether using HRT affects  a woman's chances of developing breast  and colorectal cancers, heart disease  and osteoporosis after she has gone through menopause 

Who was involved in the HRT trial? 

Two  groups of women were involved in the HRT trial. In one group, women  who had undergone hysterectomy (surgical removal  of the uterus) took either estrogen or a placebo (sugar pill). Women in the other group were also postmenopausal but they had not undergone hysterectomy. These women took either combination HRT (both estrogen  and progestin) or a placebo. The specific brand of combination medicine used in this group was Prempro. There are other brands of combination-therapy HRT available, but only Prempro was used in this study. 

I heard this study was stopped. What happened? 

The HRT trial was scheduled to end in 2005. However, researchers decided to stop the combination-therapy part  of the study in 2002  because they could see that the risks associated with combination HRT outweighed the benefits. Specifically, it was found that long-term use (5 years or more)  of combination HRT resulted in an increase in  a woman's risk of breast cancer, blood clots, heart attacks and strokes. For each of  these problems,  the increased risk was about 8 more events per 10,000 women per year, compared to women who did not use HRT. 

What should I do if I am taking combination HRT now?

If you're taking Prempro or another type of combination HRT, do not panic.  Most women will not suffer serious health problems as a result of this treatment. Visit your doctor before making any changes  to your therapy.  He or she will consider your  menopausal symptoms  and your risk for developing certain diseases,  and will give  you advice about what  you should do next. Some of your options  may be stopping treatment altogether,  taking a lower dose of medicine  or switching  to another type of treatment. Depending on  your specific risk, your treatment may not need  to change 

Are other kinds of drugs used in HRT safe? 

Researchers aren't sure, but it is possible that women who use HRT drugs other than  the one used in the WHI study are also at higher risk  for breast cancer, blood clots, heart attacks and strokes. Even so, many doctors believe that short-term use  of HRT  to control menopausal symptoms is still safe for most women.  Women who have  a history of heart disease or blood clots are at the highest risk and  should most likely not receive HRT. 

Is long-term use of HRT ever a good idea? 

HRT still offers protection against osteoporosis, decreases the risk of colorectal cancer and may help prevent Alzheimer's disease. If  your risk for these diseases is high and your risk for diseases like breast cancer or heart disease is low, long-term use of HRT may be an option for you. For women with severe menopausal symptoms, benefits of HRT may also outweigh risks. You and your  doctor will need to talk  about your personal risks and benefits before deciding whether long-term use of HRT is a good choice for you. 

Are there  other options besides HRT for treating menopausal symptoms and for lowering my risk of other diseases? 

Yes.   For some women, vaginal estrogen creams, antidepressants, soy products and certain herbal supplements offer relief from menopausal symptoms. Other  medications are available to help prevent and treat osteoporosis. Your doctor  can help  you decide which of  these treatments might be most helpful for you. 

Finally, remember that eating a healthy diet, maintaining a healthy weight, exercising regularly and quitting smoking if you smoke can help protect against heart disease, osteoporosis and some types of cancer.