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Individualizing hormone therapy: Weighing risks and benefits

As women transition into menopause, they may wish to have hormone therapy. Find out what the risks and benefits of the therapy are.

Age at HT initiation

HT dosage

A second important influence on the HT risk-benefit profile is the dose of estrogen and progestin. Evidence is substantial that low-dose HT is effective in preventing bone loss and treating menopausal symptoms with less bleeding and other side effects than higher doses.12-14 More important, lower doses are also associated with lower risks.

The Nurses' Health Study (NHS) was a prospective, observational cohort study of 70,533 postmenopausal women that investigated duration, dose, and type of HT in preventing cardiovascular disease (CVD) over 20 years of follow-up. Investigators found that an estrogen dose of 0.3 mg/day was associated with a statistically significant lower risk of both major CVD and stroke, whereas higher doses were associated with an increased risk of stroke but reduced risk of CVD. (Table 2).15