Hormone replacement therapy

Purpose of Assessment

To examine the short-term and long-term effects of HRT on quality of life for climacteric symptoms. To evaluate the effects of HRT on bone density and fractures, cardiovascular and cerebrovascular disease, and breast and endometrial cancers. To develop an economic model of fracture prevention using HRT in osteoporosis in a hypothetical cohort of women, including the potential side effects. To examine the level of compliance with HRT.

Methods

Systematic review, meta-analysis, cost-effectiveness analysis.

Primary Data Collection

Systematic literature review using computerized databases, review of reference lists of studies and a review of previous reports from other organizations. Meta-analysis of epidemiological studies with followup of subsequent fractures comparing "ever use" of estrogens to "never use". Computer simulation modelling of cost-effectiveness of preventing fractures with HRT.

Review process for the publication

Internal review by project group, SBU Board and SBU Expert Group. Additional external review by experts in the field.

Conclusions of this project

1. the impact of HRT on quality of life for women with climacteric symptoms
2. the odds ratio for fractures of women that have ever used versus never used estrogens
3. the effects of HRT on cardiovascular disease, cerebrovascular disease, breast cancer, and endometrial cancer
4. the appropriate applications of HRT.