What are the benefits and risks of long-term hormone therapy?

Hormone therapy can help ease symptoms of menopause. But it is associated with a lot of serious risks if used over the long term. Although the treatment lowers the risk of bone fractures, it increases the risk of cardiovascular disease (heart and blood vessel problems) and breast cancer.
Women’s hormone levels change during the time leading up to menopause (known as perimenopause). This can lead to hot flashes, sweats and mood swings. Some women have such severe symptoms that they start looking for treatments. One treatment option is hormone therapy with estrogen, or with a combination of estrogen and progestin. Combination drugs are generally used because estrogen can lead to growths in the lining of the womb when used alone. So estrogen-only medications are only suitable for women who have had a hysterectomy (surgery to remove their womb).
In the past it was thought that taking for a long time after menopause can protect women from serious diseases. But this assumption turned out to be wrong. On the contrary: It is now clear that this treatment actually increases the risk of certain serious diseases. These include:
- Strokes
- Heart attacks
- Blood clots in the legs or in the lungs (thromboembolism)
- Breast cancer