Hormone replacement therapy-estrogens long-term effects

Jokela H, Dastidar P, Rontu R, Salomaki A, Teisala K, Lehtimaki T, Punnonen R (2003) Effects of long-term estrogen replacement therapy versus combined hormone replacement therapy on nitric oxide-dependent vasomotor function. J Clin Endocrinol Metab 88 4348-4354... 

Tibolone is an agonist at estrogen and progestogen receptors, with weak androgenic activity. It is given as an alternative to hormone replacement therapy, without added progestogen, and has been in use for some 30 years to treat bone loss in post-menopausal women. Some long-term studies (for example over 10 years) appear to have confirmed its safety and relative freedom from adverse effects (1). In particular there is little or no increase in thrombotic events and the incidence of breast tenderness is low. 

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