A 10-year double-blind prospective study was undertaken to evaluate the effects of estrogen replacement therapy (ERT). The sample population consisted of 84 pairs of randomly chosen postmenopausal in-patients, matched for age and diagnosis. The treatment group received high-dose conjugated estrogens, cyclically with progesterone. The controls received placebos. Results revealed no statistically significant difference in the incidence of thrombophlebitis, myocardial infarction (MI), or uterine cancer. There was a lower incidence of breast cancer in the treated group. Estrogen-treated patients showed a higher incidence of cholelithiasis. Those in the treated group who began the study with elevated beta/alpha lipoprotein ratios showed a reduction in that ratio over the course of the study, while the controls either maintained or increased their ratios. The low number of cases precludes drawing any real significance from the data on diseases of low frequency. The study excludes only a high incidence of complications from estrogens.; A study involving 84 pairs of patients evaluated the effects of estrogen replacement therapy over a 10-year period. The pairs of patients were postmenopausal women matched for age and diagnosis. The treated group received high-dose conjugated estrogen, cyclically with progesterone while the control group received placebos. Thrombophlebitis, myocardial infarction, or uterine cancer incidences showed no significant differences in the 2 groups; however, there was a lower incidence of breast cancer in the treated group as well as reduced beta/alpha lipoprotein ratios. Yet the incidence of cholelithiasis was higher in the estrogen-treated group. Of the 168 in-patients, there were 7 deaths in the control group and 3 in the treated group. The results attributable to either estrogen or progesterone cannot be separated due to their concomitant use and due to the small study population, little significance can be placed on the data of diseases of low frequency.