Hormone replacement therapy is not given for:(AIIMS May 2013, Nov 2011)

Ans. d. Prevention of CAD (Ref: Novak's Gynae 14/e p1330-1333)Normal women have ovarian failure or menopause, at a mean age of 51 years, with 95 percent becoming menopausal between the ages of 45 to 55 years.Estrogen is the most effective treatment available for relief of the menopausal symptoms that many women experience, including hot flashes, vaginal dryness, urinary symptoms, and emotional lability.However, data from the Women's Health Initiative showed no cardiovascular benefit with unopposed estrogen and a small increase in risk with combined therapy.Estrogen is an option for the prevention of osteoporosis in perimenopausal women, estrogen-progesterone therapy reduces fracture risk at a cost of increase in the incidence of breast cancer, coronary heart disease, stroke and venous thromboembolism, or in the case unopposed estrogen, an increase in stroke and thromboembolism.At this time, post-menopausal hormone therapy, either unopposed estrogen or combined estrogen-progestin therapy should not be initiated for prevention of CUD.Hormone Replacement TherapyEstrogen is the most effective treatment available for relief of the menopausal symptoms that many women experience, including hot flashes, vaginal dryness, urinary symptoms, and emotional lability.However, data from the Women's Health Initiative showed no cardiovascular benefit with unopposed estrogen and a small increase in risk with combined therapy.Estrogen is an option for the prevention of osteoporosis in perimenopausal women, estrogen-progesterone therapy reduces fracture risk at a cost of increase in the incidence of breast cancer, coronary heart disease, stroke and venous thromboembolism, or in the case unopposed estrogen, an increase in stroke and thromboembolism.At this time, pwst-menopausal hormone therapy, either unopposed estrogen or combined estrogen-progestin therapy should not be initiated for prevention of CHD.In addition, postmenopausal hormone therapy is no longer considered to be first line drug for prevention and treatment of osteoporosis.Bisphosphonates or raloxifene are recommended as first line drugs for prevention and bisphosphonates for treatment of established osteoporosis.