Progestogens: New Approaches

The benefits of hormone replacement therapy (HRT) are numerous: It provides relief of menopausal symptoms, reduces the risk of osteoporosis and accompanying fractures and may potentially aid in the prevention of various other illnesses, including Alzheimer’s disease and cardiovascular disease (CVD) [1 – 4]. Despite the established and potential benefits of HRT, which have been shown to outweigh its possible risks, fewer than one-half of eligible women in the United States are currently using it [1,5. Furthermore, only a fraction of current users will continue therapy for more than 2 years [6]. Part of the reason for this problem with discontinuation is the lack of consistency in the literature regarding risks and benefits. For example, the American Heart Association recently suggested in a position paper that there is no benefit to taking estrogen for secondary prevention of CVD and questioned whether there is any benefit to it in primary prevention [7].