Are estrogens indicated for the treatment of postmenopausal women?

Abstract

A woman in the U.S. can now expect to live for 30 years or more past the menopause in a state of estrogen deprivation. Hypoestrogenic-associated conditions can be managed by a variety of medical regimens and lifestyle changes, but estrogen replacement therapy (ERT) is the most specific and universal treatment for all of the above conditions. Although concern for potential risks has limited its acceptance, the benefits of ERT extend beyond the amelioration of estrogen deprivation symptoms. Evidence is accumulating that ERT may offer protection from cardiovascular atherogenic disease. Several of the risks that have been associated with continuous ERT, such as endometrial cancer and breast cancer, are significantly reduced with the use of cyclic progestogens. Moreover, any concern arising from the use of conjugated estrogens and synthetic progestogens are being addressed by the recent introduction of orally active natural estrogen and soon, progesterone. With the demonstrated efficacy and safety of ERT, such therapy should be considered for all postmenopausal women.