Long-term benefits/risks of HT

Women who start or restart combined hormone therapy (HT) or estrogen therapy alone about 15 years after menopause are at greater risk for cardiovascular disease and venous thromboembolism, at least during the first few years of treatment, according to the results of the Women's International Study of Long Duration Oestrogen After Menopause (WISDOM). However, the jury is still out regarding the long-term risks and benefits of HT when it is started around the time of menopause for climacteric symptom control.

The randomized controlled trial of postmenopausal women aged 50 to 69 years was halted during recruitment after a median follow-up of almost one year because of publication of early results from the Women's Health Initiative Study, which indicated the same outcomes.

The authors of the WISDOM trial concluded that the lack of overall disease prevention benefit combined with the potential risks associated with a delayed or second start of HRT must be weighed against potential improvements in quality of life, and that additional research on the topic is sorely needed.