A study published in this week’s JAMA reviewed the data for hormone replacement therapy in women using conjugated equine estrogens (CEE) plus medroxyprogesterone acetate (MPA). They looked at the initial Women’s Health Initiative and 13 years of follow-up ending in 2010. They concluded that hormone replacement therapy (with CEE and MPA) maybe safe for some women to use for symptom relief of menopausal symptoms such as hot flashes during early menopause. They do not recommend it for prevention of coronary heart disease or dementia. Hip fracture rates were reduced but the risk of using hormones did not outweigh the benefits. The most significant concerns were the increased risks of stroke and venous thrombosis, as well as gallstones and urinary incontinence, in both younger and older women who used hormone replacement therapy.
Starting hormone therapy whether it is bio-identical or CEE/ MPA requires a review of risks and benefits with your provider. Close follow up and frequent monitoring is recommended for those who chose to use hormones for management of their symptoms