HRT Not Recommended for Prevention of Chronic Conditions

Task force concludes that moderate harms of hormone replacement outweigh potential benefits

MONDAY, Oct. 22 (HealthDay News) -- The benefits of hormone replacement therapy to prevent chronic conditions in postmenopausal women do not outweigh the harms, according to a recommendation statement from the U.S. Preventive Services Task Force (USPSTF) published online Oct. 23 in the Annals of Internal Medicine.

Members of the USPSTF reviewed the literature to update evidence regarding the benefits and harms of menopausal hormone therapy to prevent chronic conditions in postmenopausal women, and whether the benefits and harms differ according to population subgroups.

For postmenopausal women considering hormone therapy for primary prevention of chronic medical conditions, the USPSTF gave level D recommendations against the use of combined estrogen and progestin and against the use of estrogen in postmenopausal women who have had a hysterectomy. Combined estrogen and progestin provided moderate benefit in reducing fractures, but was associated with an increased risk of stroke, dementia, gallbladder disease, and urinary incontinence, and a small increase in invasive breast cancer incidence and breast cancer deaths. Estrogen alone also reduced the incidence of fractures and was associated with a reduced risk of developing or dying of breast cancer. However, estrogen correlated with a moderate increase in the risk of stroke, gallbladder disease, and urinary incontinence, and a small increase in deep vein thrombosis risk. These recommendations are not applicable for women considering hormone therapy for the management of menopausal symptoms or for women younger than 50 years of age who have undergone surgical menopause.

"[We] conclude with high certainty that the chronic disease prevention benefits of combined estrogen and progestin do not outweigh the harms in most postmenopausal women," members of the task force write.

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