The use of estrogen (ERT) or estrogen and a progestin (HRT) is highly effective, compared with placebo, in suppressing the symptoms of the "hot flash." Even low doses are effective. Genital atrophy, vaginitis, and dyspareunia are all relieved by estrogen therapy, which may be systemic or local (by means of estrogen-containing cream). Estrogen replacement has been shown to be effective not only in reducing calcium loss, but also in preserving bone density, even at relatively low doses. Estrogen replacement also reduces the actual number of fractures in estrogen-deficient women.
Good health is more than just the absence of disease. Part of the definition may be based on improvement, in the sense of the well-being and improved quality of life that have been demonstrated in most studies of HRT. If the patient has no contraindications to therapy and is willing to assume the effort and cost of long-term therapy, all of the beneficial effects of HRT should be considered.
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