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Are You Comfortable Prescribing HRT?

POLL: How do you compare with your colleagues in your comfort level for prescribing hormone replacement therapy for symptoms of menopause.

Vasomotor symptoms and other symptoms related to decreased estrogen levels from menopause are costly to women as well as the health care system. Women who experience them are burdened with hot flashes, sleep disturbances, and a variety of other issues that can diminish their quality of both home and work life, including dyspareunia, anxiety, depression, irritability, and memory impairment. Also, new research shows that untreated vasomotor symptoms are associated with significant increases in healthcare utilization, work loss, and cost burden.

The one treatment that most effectively manages many of these symptoms is hormone therapy, but a recent analysis has shown that use of hormone replacement therapy is associated with an increased risk of the two most common forms of ovarian cancer. Also, another analysis has shown that HRT isn't cardioprotective. Yet other new research shows that some women can experience hot flashes for up to 14 years.

Considering these new findings, how comfortable are you in prescribing HRT to women who experience moderate to severe vasomotor symptoms? (Assume there are no contraindications based on patient history.)