Pros And Cons

One encouraging development is the increasing number of options for preventing bone loss and heart disease. The American Heart Association, for example, recommends the use of cholesterol-lowering drugs as the front-line treatment of choice for women whose blood lipids remain high despite diet and exercise. Similarly, there are new drugs designed to combat bone loss, including estrogen look-alikes that appear to act as antigrowth factors in the breast. As new and better drugs become available, the case for long-term hormone replacement will weaken.

For the time being, women should not rule out long-term hormone therapy, but they should weigh the pros and cons with great care. "This is just one study," says Schairer. "I'm not going to hang my hat on it. But it does provide an impetus for women to discuss alternatives with their doctors."