Ans. c. Prevention of coronary artery disease (Ref: Novak's Gynae 14/e p1330-1333)HRT in post-menopausal women is effective treatment available for relief of the menopausal symptoms hot flashes, vaginal dryness, urinary symptoms, emotional lability, and osteoporosis. Coronary artery disease is an absolute contraindication for HRT."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 he initiated for prevention of CHD."Absolute Contraindications to HRT* Undiagnosed vaginal bleedingQ* Severe liver diseaseQ* PregnancyQ* Coronary artery disease (CAD)Q* Venous thrombosisQ* Well-differentiated and early endometrial cancerQ (once treatment for the malignancy is complete, is no longer an absolute contraindication)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 therapyQ.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 CHDQ.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 osteoporosisQ.