Women entering menopause notice many signs of the loss of the female hormone, estrogen. Hot flashes, flushes, and a dry vagina are common complaints. Women often seek hormonal treatment. Yet, the most important reasons for hormonal treatment are heart disease and osteoporosis, which is known as thinning of the bones.

Preventing these long term problems is the main goal of estrogen replacement therapy, or ERT. Estrogen is given in the form of pills or patches to replace what the body no longer makes. It relieves the hot flashes, reduces the loss of calcium from the bones, and increases the good cholesterol in our blood.

Most women are able to take ERT, but the benefits and risks must be weighed. Estrogen may not be appropriate for women with:
* vaginal bleeding without a known reason,
* liver disease or poor liver function,
* recent blood clots,
* cancer of the breast, or
* cancer of the uterus.

Estrogen taken alone increases the risk for cancer in the uterus. When it is combined with progesterone, another female hormone, there is less chance of cancer of the uterus. This combination is the safest way to take estrogen and still get the benefits. After a complete review of the risks and benefits of this therapy and an exam, you may choose from three ways to take ERT:
* Cyclic estrogen taken by mouth or patch daily each month, with progesterone taken for about 14 days each month.
* Combined estrogen and progesterone taken daily.
* Estrogen taken daily without progesterone. Women who have no uterus use this method.

The dosage of the estrogen protects the heart and bones as well as, stops the symptoms of hot flashes.

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