Hormonal strategies of the menopause.

A woman at the age of 50 in the United States has a life expectancy of approximately 30 years. The menopausal years, the symptoms associated with menopause, and concurrent conditions associated with these age groups are of major importance, since women may live up to one third of their lives in menopause. In this discussion, the physiologic conditions associated with menopause, including osteoporosis, cardiovascular disease, and breast cancer, are considered, with specific assessment of risks and benefits of hormone replacement therapy. Specific hormone replacement regimens are reviewed, along with non-estrogenic approaches to osteoporosis therapy. The long-term benefits of estrogen on female life expectancy are reviewed, balancing cardiovascular and osteoporosis benefits within the context of long-term effects on breast cancer risk.