[Hormone replacement Up-to-date. Menopause in women and hormone replacement therapy (HRT). Indications for HRT in postmenopausal women].

It has been generally accepted that it is quite sensible to administer hormone replacement therapy (HRT) in women to compensate for the estrogen deficiency that occurs as they approach menopause and that, given its broad-ranging efficacy, it has a huge benefit to offer to these women. However, it has been demonstrated in 2002 in the NIH-initiated Women's Health Initiative (WHI) trial that HRT may be associated with risk depending on whom it is used for. Thus, HRT has had a high profile in recent years. While the findings from the WHI trial are compelling in their own right, on closer examination, it has become clear that they do not necessarily translate into local practice here in Japan. Again, a further examination of HRT as a treatment modality reveals that the benefit and risk profile of HRT varies greatly depending on the timing for its initiation,the kind of estrogen or progesterone used and their route of administration and dosing. Therefore, in deciding to go for HRT, it needs to be weighed carefully for its benefit and risk in individual patients, and informed consent obtained for its administration, in view of the risk associated with its use versus its enormous benefit.