H is useful in all except
Coronary aery disease [Ref Harrison 16th/e p 30, K.D.T. 5thie p 2761 H refers to the use of oestrogen treatment in order to reverse or prevent problems due to the loss of ovarian hormone secretion after the menopause, whether physiological or induced. The tissues sensitive to estrogen include brain, bone, skin cardiovascular and genitourinary tissues. Consequently the two aims of hormone replacement therapy are: (i) To reduce time everyday symptoms of oestrogen loss ; hot flushes, sleeplessness, lethargy, depression and vaginal dryness. All types of H (oestrogen with or without progesterone) are effective in reducing the hot flushes experienced by more than 50% of postmenopausal women. The benefit is most during the first year of treatment when 80% of women repo a reduced likelihood of flushes. The other major use from H is the relief of vaginal dryness. Vaginal administration is the most effective route for treatment of dyspareunia and related symptoms. (ii) To prevent fractures Estrogen prevents osteoporotic fractures Effect of H on coronary aery disease Until recently it was believed that beneficial effect of estrogen on lipids, decrease the risk of coronary aery disease in women on hormone replacement therapy. However two recent landmark clinical trials "Hea and Estrogen progestin replacement study (HERS)" and "women health initiative (WHI)" have radically altered the approach of H. According to these trials, the benefits and harms of these therapy are:
>Flushing
>Osteoporosis
>Vaginal atrophy
Coronary hea disease