In all cases, benefits and risks of Hormone Replacement Therapy (HRT) must be evaluated individually. A recent study (Women’s Health Initiative) shows that estrogen and a certain progestin (MPA) taken together on a daily basis leads to an increased risk of heart disease, blood clots and breast cancer, while reducing the risk of hip fracture and colon cancer. The same study (WHI) is still ongoing for women who have had a hysterectomy and take estrogen only. It is understandable that concerns about breast cancer are at the forefront of most women’s thoughts. A new class of medications, Selective Estrogen Receptor Modulators (SERMS) is available. At present, one SERM (Tamoxifen) is indicated by the FDA for the reduction of breast cancer risk, while another (Evista, raloxifene) is indicated for prevention and treatment of osteoporosis. Raloxifene has a beneficial effect on bone density and does not cause uterine bleeding. Please feel free to ask us about these medications.