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Long-term hormone replacement therapy used to be routinely prescribed for postmenopausal women to relieve hot flashes and other menopause symptoms. Hormone replacement therapy was also thought to reduce the risk of heart disease.

However, hormone replacement therapy — or menopause hormone therapy, as it's now called — has had mixed results. Many of the hoped-for benefits failed to materialize for large numbers of women.

The largest randomized, controlled trial to date actually found a small increase in heart disease in postmenopausal women using combined (both estrogen and progestin) hormone therapy. For women in this study using estrogen alone, there was no increased risk of heart disease.

Other studies suggest that hormone therapy, especially estrogen alone, may not affect — or may even decrease — the risk of heart disease when taken early in postmenopausal years.

But clinical studies can be confusing to interpret into practice. Study outcomes can be affected by many factors, such as the ages of the study participants, the time elapsed since menopause and how long hormone therapy is used. Continued research will help doctors more clearly understand the relationship between menopause hormone therapy and heart disease.