The risk and benefits of HRT should be evaluated for all women who undergo a premature menopause as a result of gynaecological malignancy to reduce menopausal symptoms and protect against cardiovascular and skeletal morbidity. There is no evidence to suggest a higher rate of disease recurrence in women using HRT in comparison to nonusers in the majority of gynaecological malignancies. Routine histological testing of tumours for hormone receptor status is an achievable goal and may help to stratify patients further into low and high-risk groups for hormone therapy.