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Hor­mone replace­ment ther­a­py (HRT) in menopause is med­ical treat­ment in sur­gi­cal­ly menopausal, per­i­menopausal and post­menopausal women. Its goal is to mit­i­gate dis­com­fort caused by dimin­ished cir­cu­lat­ing estro­gen and prog­es­terone hor­mones in menopause. Com­bi­na­tion HRT is often rec­om­mend­ed as it decreas­es the amount of endome­tri­al hyper­pla­sia and can­cer asso­ci­at­ed with unop­posed estro­gen ther­a­py. The main hor­mones involved are estro­gen, prog­es­terone and prog­estin. Some recent ther­a­pies include the use of andro­gens as well. The 2002 Wom­en’s Health Ini­tia­tive of the Nation­al Insti­tutes of Health found dis­parate results for all cause mor­tal­i­ty with hor­mone replace­ment, find­ing it to be low­er when HRT was begun ear­li­er, between age 50–59, but high­er when begun after age 60. In old­er patients, there was an increased inci­dence of breast can­cer, heart attacks and stroke, although a reduced inci­dence of col­orec­tal can­cer and bone frac­ture. Some of the WHI find­ings were again found in a larg­er nation­al study done in the UK, known as The Mil­lion Women Study. As a result of these find­ings, the num­ber of women tak­ing hor­mone treat­ment dropped pre­cip­i­tous­ly. The Wom­en’s Health Ini­tia­tive rec­om­mend­ed that women with non-sur­gi­cal menopause take the low­est fea­si­ble dose of HRT for the short­est pos­si­ble time to min­i­mize asso­ci­at­ed risks. The cur­rent indi­ca­tions for use from the U.S. Food and Drug Admin­is­tra­tion include short-term treat­ment of menopausal symp­toms, such as vaso­mo­tor hot flash­es or uro­gen­i­tal atro­phy, and pre­ven­tion of osteo­poro­sis. In 2012, the Unit­ed States Pre­ven­tive Task Force con­clud­ed that the harm­ful effects of com­bined estro­gen and prog­estin are like­ly to exceed the chron­ic dis­ease pre­ven­tion ben­e­fits in most women. A con­sen­sus expert opin­ion pub­lished by the The Endocrine Soci­ety stat­ed that when tak­en dur­ing per­i­menopause, or the ini­tial years of menopause, hor­mon­al ther­a­py car­ries sig­nif­i­cant­ly few­er risks than pre­vi­ous­ly pub­lished, and reduces all cause mor­tal­i­ty in most patient sce­nar­ios. The Amer­i­can Asso­ci­a­tion of Clin­i­cal Endocrinol­o­gy also released a posi­tion state­ment in 2009 that approved of HRT in appro­pri­ate clin­i­cal scenarios.