Need to balance benefits and risks of long-term hormone therapy in postmenopausal women

In relatively healthy postmenopausal women, using combined continuous HT for 1 year increased the risk of a heart attack from about 2/1000 to 3–7/1000, and increased the risk of venous thrombosis from about 2/1000 to 4–11/1000. With longer use, HT also increased the risk of stroke, breast cancer, gallbladder disease and death from lung cancer. Oestrogen-only HT increased the risk of venous thrombosis after 1–2 years' use: from 2/1000 to 2–10/1000. With longer use, it also increased the risk of stroke and gallbladder disease, but it reduced the risk of breast cancer (after 7 years' use) from 25/1000 to 15–25/1000. Among women over 65 years of age taking continuous combined HT, the incidence of dementia was increased. Risk of fracture was the only outcome for which results showed strong evidence of clinical benefit from HT (both types).