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To evaluate the effects of different hormone replacement therapy (HRT) protocols on mammographic findings. One-hundred-eighty-two women in menopause were recruited for this prospective study. Breast examination was performed and four basal mammograms were obtained in all cases. Eighty of the cases received HRT by estrogen only; 40 used combined pills of estrogen plus progestagen sequentially; 44 used combined pills of estrogen plus progestagen continuously; 18 used tibolone. Breast examination and mammography were repeated after 11.6±2.1 months of HRT. Mammographic parenchymal density was found to be increased in all cases (17.6%). This finding was most prominent in the continuous combined estrogen plus progestagen group (25%) and the lowest in the tibolone group (5.5%). The use of estradiol resulted in more increased density than conjugated estrogen. The increase in the mammographic density is related directly with breast tenderness. Hormone replacement therapy is not contraindicated in the cases of breast disease without atypia. The increase in mammographic density was found to be higher in obese women.