A long-term look at the effects of hormone replacement therapy in women is offering reassurance the treatment can be safe.

"Hormone therapy is very reasonable for treatment of hot flashes, menopausal symptoms among women who have impaired quality of life due to these symptoms -- and especially if they're in early menopause," said Dr. JoAnn Manson.

Dr. Manson and colleagues at Brigham and Women's Hospital in Boston followed up with more than 27,000 women, nearly two decades after taking hormone replacement. They found the treatment did not lead to early death from any cause.

"There was no increase in total mortality or in death rates from cardiovascular disease or cancer," Dr. Manson said.

A previous look at the same set of women on hormone therapy uncovered worrisome risks including blood clots, stroke and breast cancer.

Experts say the science has evolved since then, so doctors now have a better understanding of the potential problems, as well as benefits.

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