Approximately 38% of postmenopausal women in the United States use hormone
replacement therapy.1 In 2000, 46 million prescriptions
were written for Premarin (conjugated estrogens), making it the second most
frequently prescribed medication in the United States and accounting for more
than $1 billion in sales, and 22.3 million prescriptions were written for
Prempro (conjugated estrogens plus medroxyprogesterone acetate).2
While US Food and Drug Administration–approved indications for hormone
therapy include relief of menopausal symptoms and prevention of osteoporosis,
long-term use has been in vogue to prevent a range of chronic conditions,
especially heart disease. Estrogen alone was the dominant hormone until the
increased risk of endometrial cancer led to the addition of progestins for
women with an intact uterus. Since the mid-1980s, combined estrogen/progestin
use has steadily increased.3
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