Women had been told for decades that estrogen taken with progestin would not only ease hot flashes and insomnia but help preserve bone strength，mental acuity and，most important，heart health. There's no question that HRT can ease the acute symptoms of menopause，and the claim about bone strength had held up to scrutiny. But after observing more than 16,000 women for roughly five years，researchers found conclusively that hormones raise the risk of heart attack，stroke，blood clots and breast cancer.
The announcement caused a near panic among the more than 13 million American women now on hormone-replacement therapy. Fortunately，the study didn't uncover huge，unimagined dangers to patients. But for millions of women juggling the pros and cons of long-term HRT，the new findings offer something virtually unprecedented，which is clarity. Even a small risk to individuals can have big consequences when applied to a large population.
The study suggests that，on balance，a group of 10,000 long-term estrogen users would suffer 31 excess health crises each year（strokes，heart attacks，blood clots，breast cancers），while avoiding only 11 bone fractures and colon cancers. That's a net increase of20. If 100,000 people take up long-term HRT，they'll suffer 200 of these needless events each year. A million long-term estrogen users will experience 20,000 of them annually--which means20,000 over the course of a decade. This is no way to prevent hip fractures.
Short-term use is a different story. The study didn't turn up unacceptable risks among womentreated for less than five years，and experts agree there is still no better treatment for the hot flashes，mood swings and insomnia that many women experience around the time of menopause.
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