Postmenopausal hormone replacement therapy is helpful in relieving menopausal vasomotor symptoms and vaginal atrophy and can prevent osteoporosis; however, attendant risks include breast cancer, thromboembolism, gallbladder disease, stroke, CHD, dementia, and hypertriglyceridemia. Decision making must weigh these risks and benefits and also include potential benefits on mood, colorectal cancer prevention, and hip fracture reduction. Some areas, such as ovarian cancer risk and the impact of combination estrogen-progestin versus unopposed estrogen on risk, remain unclear. The physician and patient need to carefully assess, discuss, and monitor the individual's symptoms and risks when considering HT use. For those with contraindications or concerns about HT, there are alternative therapies of variable efficacy for vasomotor symptoms and vaginal atrophy.
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