Hormone replacement therapy: who should be treated?

The last decade has been characterized by a careful review of the risks and benefits of hormone replacement therapy (HRT). Various types and doses as well as different combinations, may offer different advantages in different groups of women. Women with premature or early menopause may benefit from HRT, at least until the age at which natural menopause usually occurs. The most favorable benefits of HRT is in symptomatic younger women (50-59 years) within 10 years since menopause. Beside the effect on symptoms, these patients have additional benefits such as reduction in cardiovascular disease (CVD), osteoporotic fractures, and overall mortality. In older women low-dose or ultra-low-dose HRT may have a better safety profile than standard dose oral combinations. Currently, available evidence does not support the use of HRT for the sole osteoporosis or CVD and cognition decline prevention.