This review article looks at the evidence for the relationship between menopause, use of hormone therapy and risk of stroke.  The following are discussed:

• Epidemiology of stroke in women during midlife

- Incidence

- Prevalence

• Menopause and stroke

- Menopause: hormonal changes and risk factors for early onset

- Menopause and risk factors for stroke

- Endogenous hormones and stroke

- Age at menopause and stroke

• Hormone therapy and stroke

- Completed clinical trials

- Clinical trials in progress

- Route of administration

- Dose of hormone therapy

- Monotherapy versus dual therapy

- The timing hypothesis for hormone therapy and stroke

- Clinical guidelines for hormone therapy

The authors note that hormone therapy is recommended only for treatment of vasomotor symptoms because of the stroke risk associated with it, and some formulations may be safer than others. More research is needed to understand which women are at greatest stroke risk during midlife and to identify the safest formulation, dose, and duration of hormone therapy that can be used to treat vasomotor symptoms without increasing the risk of stroke.