Q: I just turned 50 and have begun to have mild menopausal symptoms. I am confused by the many pros and cons about the use of estrogen replacement therapy after menopause. What is your opinion?
A: Two unquestioned benefits of estrogen replacement therapare easing or eliminating menopausal symptoms, such as hot flashes, and reducing the risk of developing osteoporosis. Although the evidence is not yet conclusive, most studies have shown estrogen therapy also improves the levels of certain blood lipids and reduces the risk of a heart attack. On the negative side, estrogen replacement clearly increases the danger of uterine cancer and possibly increases the danger of breast cancer.
While many women barely notice menopausal symptoms, about 10 percent have severe ones. It seems quite reasonable to use estrogen replacement when these symptoms are very troublesome. And symptoms usually do not recur if estrogen is discontinued after a few years.