Indications for hormone therapy: the post-Women’s Health Initiative era Susan D. Reed, MD, MPH a,b,c, * , Katherine M. Newton, PhD c , Andrea Z. LaCroix, PhD b,c a Department of Obstetrics and Gynecology, University of Washington/Harborview Medical Center, 325 9th Avenue, Box 359865, Seattle, WA 98115, USA b Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA c Center for Health Studies, Group Health Cooperative, 1430 Minor Avenue, Suite 1600, Seattle, WA 98101, USA Long-term postmenopausal hormone therapy (HT) was commonly advised for women older than 50 years from the 1980s until mid-2002, with the expectation that it would ameliorate menopausal symptoms, prevent chronic diseases, and prolong life. This recommendation was based on observational data and expert opinion. Two large-scale randomized controlled trials, the Heart and Estrogen/Progestin Replacement Study (HERS) [1] and the Women’s Health Initiative (WHI) estrogen-plus- progestin (EPT) trial [2], brought enthusiasm for widespread menopausal hormone therapy to a halt by demonstrating no evidence for secondary prevention of heart disease [1] and increased rates of cardiovascular disease (CVD) [3], stroke [4], dementia [5], thromboembolism [2], and breast cancer [6], which outweigh the benefits of decreased risk of fracture [7] and colon cancer [8]. This finding is in contradistinction to the estrogen therapy (ET) portion of WHI, which only demonstrated a statistically increased risk for deep vein thrombosis and stroke [9]. Aggregate information from the WHI and HERS in more than 300 publications has shed light on the relatively short-term effects of HT (up to 4–5 y) in women aged 50 to 69 years. The views expressed in this work are those of the authors and are not meant to represent the entire WHI community. * Corresponding author. Department of Obstetrics and Gynecology, University of Washington/Harborview Medical Center, 325 9th Avenue, Box 359865, Seattle, WA 98115. E-mail address: reeds@u.washington.edu (S.D. Reed). 0889-8529/04/$ - see front matter Ó 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.ecl.2004.07.008 Endocrinol Metab Clin N Am 33 (2004) 691–715