The International Menopause Society (IMS) has developed consensus clinical recommendations regarding hormone replacement therapy (HRT) and heart disease. The IMS is recommending that while the clinical benefits of HRT are widely accepted for the cure of menopausal symptoms, the improvement of quality of life and the prevention of osteoporosis, there is no clear reason to commence HRT solely or primarily to confer a cardiovascular benefit. Equally, there is no compelling evidence for discontinuing, or initiating, therapy because of concern about cardiovascular risk, it says. The consensus paper will be published in December in Climacteric.