In a recent paper, using a case history of a patient with classical menopausal symptoms, Martin and Manson have reviewed in short the recent data and controversies over hormone replacement therapy (HRT) and discussed hormonal regimens (oral, transdermal) and dosage, duration of therapy and alternative treatment options . The main motif of the article is safety, namely, how to balance the potential benefits of HRT against the potential risks in early and late menopause, and ways to identify patients in whom this balance would be the most, or least, favorable. For example, the authors suggest to incorporate the Framingham Score (a tool for assessment of the 10-year risk for coronary heart disease) in decision-making and consider a cut-off point of higher than 20% risk in the first 5 years of menopause, or higher than 10% risk during years 6-10 after menopause, as a negative argument for prescribing HRT.
Department of Medicine T, Ichilov Hospital, Tel-Aviv, Israel
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