The overall increased risk of serious adverse effects, such as breast cancer, stroke and pulmonary embolism, with long-term hormone replacement therapy. Some hormone products, which may be referred to as bioidentical hormones, are available without a prescription. Research shows that long-term use of combination hormone therapy (for 5 years or more) increases the risk of breast and ovarian cancer, heart disease, stroke, and pulmonary embolism (blood clots in the lungs). New evidence does not indicate if the effect on diabetes continues after stopping hormone therapy, so there is no need to update this area. Tibolone showed inconsistent effects on breast cancer: 2 analyses showed no association with breast cancer and 2 suggested a higher risk of breast cancer compared to placebo, the absence of HRT, or combined HRT (10,8.You may have heard claims that these products are more natural, effective and safe than HRT, but there is no scientific evidence to prove this).
Hormone replacement therapy may still be useful in relieving menopausal symptoms in the short term if other treatments don't work and the symptoms are severe. Research suggests that the risks of long-term use of combined hormone replacement therapy outweigh the benefits for most women. The effects varied depending on whether the use of HRT was current or long-term, the duration of treatment, and whether HRT was used with estrogen alone or combined. The risks of any serious side effect are usually very low and depend on the type of hormone replacement therapy you're taking, how long you're taking it, and your own health risks.
In a Cochrane review (it was suggested that, compared to combined hormone replacement therapy, tibolone had no effect on cardiovascular, cerebrovascular, or thromboembolic events). New evidence also indicated an increased risk of venous thromboembolism with HRT and an uncertain effect of tibolone on venous thromboembolism.
This section of the guide on the long-term benefits and risks of hormone replacement therapy should not be updated.
The analyses suggested an increase in cardiovascular mortality in the first year after stopping HRT, but no effect more than one year after stopping HRT. Menopause is the natural time in a woman's life when her ovaries stop producing the hormones estrogen and progesterone and her menstrual periods stop. The increased risk of ovarian cancer is already recognized in the technical specifications of hormone replacement therapy products.We identified 4 cohort studies (75, 76, 82, 11), 1 RCT (7) and 1 Cochrane review () that measured the effects of the use of hormone therapy on mortality (one study specified that the outcome was mortality not related to breast cancer) (table 20 of the appendix to the data tables).
