When menopause sets in many women experience physical and psychological changes. These changes are mostly due to the deficiency of female hormones, namely estrogen and progesterone. To counteract these changes, these hormones are given to women and this is called “hormone replacement therapy” (HRT).
Initially, in the 1950’s estrogen1 alone was used, but 25 years ago the risk of endometrial cancer emerged. Hence in the 1980’s progesterone was added. A randomized trial of the combined therapy was started which showed increased risk of carcinoma of breast, coronary heart disease, stroke and venous thromboembolism, hence the trial was stopped early2
Later on other drugs, like Tibolone,3 were introduced, which is a synthetic steroid with weak estrogenic, androgenic and progesterone like properties. Then, selective estrogen receptor modulators (SERMS), which include raloxifene4 were introduced. This is used in the treatment of osteoporosis in postmenopausal women and to prevent vertebral fractures. Then Biphosphonates were used for osteoporosis, but later were shown that they promote bones to become brittle.5
Key words: HRT, estrogens, menopause
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