US Task Force Recommends Against Hormone Therapy for Postmenopausal Women

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(ChemotherapyAdvisor) – Citing increased risk of breast cancer with estrogen plus progestin, the U.S. Preventive Services Task Force (USPSTF) upheld its 2005 recommendation against the use of hormone therapy for postmenopausal women, according to a statement published in Annals of Internal Medicine online October 23.

Specifically, USPSTF recommended against use of estrogen and progestin for the prevention of chronic medical conditions in postmenopausal women and the use of estrogen alone for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy, noted Virginia A. Moyer, MD, MPH; on behalf of the USPSTF.

“This recommendation applies to postmenopausal women who are considering hormone therapy for the primary prevention of chronic medical conditions,” the recommendation states. “It does not apply to women who are considering hormone therapy for the management of menopausal symptoms, such as hot flashes or vaginal dryness. It also does not apply to women younger than 50 years who have had surgical menopause.”

After reviewing 51 articles published since 2002, the Task Force concluded risks associated with hormone therapies outweighed any benefits of preventing chronic disease.

While estrogen alone decreased risk for breast cancer, estrogen plus progestin increased risk for breast cancer as well as probable dementia. Breast cancer risk was found to increase for women with prior oral contraceptive use, prior menopausal estrogen plus progestin therapy, or current smoking.

Both estrogen alone and estrogen plus progestin reduced the risk of fractures; however, the risk for stroke, thromboembolic events, gallbladder disease, and urinary incontinence was increased.

According to the Task Force, a woman in the United States who reaches menopause can expect to live another 30 years, during which time her risk is approximately 30% for coronary heart disease, 22% for dementia, 21% for stroke, 15% for hip fracture, and 11% for breast cancer.

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