The primary goals of estrogen replacement therapy are:

	To relieve symptoms such as hot flashes, vaginal dryness, and urinary problems
	To help prevent osteoporosis
	To help prevent atherosclerosis and coronary artery disease

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Discuss with your doctor the potential benefits and the the risks before deciding whether to use estrogen replacement therapy. Side effects of estrogen include nausea, breast discomfort, headache, and mood changes.

Postmenopausal women who take estrogen without progesterone have an increased risk of endometrial cancer (cancer of the lining of the uterus). The increased risk is related to the dose and duration of estrogen therapy. If a woman has abnormal bleeding from the vagina, a biopsy of the uterine lining may be performed to determine whether she has endometrial cancer. Taking progesterone in addition to estrogen can almost eliminate the risk of endometrial cancer. Progesterone doesn't appear to negate estrogen's beneficial effect on cardiovascular disease.

For more on progesterone, refer to our section Progesterone. This section has a thorugh description of progesterone and its effects.

Many women are fearful of starting ERT because of the fear of catching breast cancer. Indeed, it has been shown that people who take HRT has an increased chance of having breast cancer as compared to those you don't. (For a detailed description of this issue along with the results from clinical studies, refer to our section: Risks/Dangers of Estrogen Use (HRT) Estrogen therapy may not be appropriate for you if you have a high risk of developing breast cancer. However, for women who are prone to osteoporosis and heart disease and who are at low risk for developing breast cancer, the benefit gained from estrogen therapy outweighs the risk.

The risk of developing gallbladder disease is modestly increased during the first year of estrogen replacement therapy.

Generally, estrogen replacement therapy is not prescribed for women who have or have had breast cancer or advanced endometrial cancer or who have genital bleeding of unknown cause, acute liver disease, or a blood clotting disorder. Estrogen replacement therapy is not prescribed for women who have chronic liver disease or acute intermittent porphyria.

Nowadays, estrogen is hardly ever given individually. This is because taking estrogen alone increases your risk of endometrial or uterine cancer. Thus estrogen and progestin supplements are used together. They are usually given orally, as a cream, injection, suppository or through a skin patch. Progestin can cause side effects such as irregular bleeding, headaches, bloatedness, and breast swelling and pain. You may even develop an artificial monthly period, depending on the dosage regimen you're on.  For more information on administering HRT refer to:

How HRT Is Administered: Application of Estrogen

How HRT Is Administered: Application of Progesterone/Progestin

Ways of Taking HRT

Your doctor may recommend HRT to help prevent cardiovascular disease and osteoporosis, particularly if these diseases run in your family. Your doctor may prescribe a vaginal estrogen cream to help stop the thinning of vaginal tissues and improve lubrication. If you have had breast cancer, endometrial cancer, active liver disease or blood clots, there are increased risks associated with taking hormone replacement therapy.