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Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions

Clinical Summary of U.S. Preventive Services Task Force Recommendation

Release Date: October 2012


Population Postmenopausal women Postmenopausal women who have had a hysterectomy
Recommendation Do not prescribe combined estrogen and progestin for the prevention of chronic conditions.
Grade: D
Do not prescribe estrogen for the prevention of chronic conditions.
Grade: D
Risk Assessment This recommendation applies to the average-risk population. Risk factors for a specific chronic disease or individual characteristics that affect the likelihood of a specific therapy-associated adverse event may cause a woman's net balance of benefits and harms to differ from that of the average population.
Preventive Medications Although combined estrogen and progestin therapy (specifically, oral conjugated equine estrogen, 0.625 mg/d, plus medroxyprogesterone acetate, 2.5 mg/d) decreases the risk for fractures in postmenopausal women, there is an accompanying increased risk for serious adverse events, such as stroke, invasive breast cancer, dementia, gallbladder disease, deep venous thrombosis, and pulmonary embolism.

Estrogen therapy (specifically, oral conjugated equine estrogen, 0.625 mg/d) decreases the risk for fractures and has a small effect on the risk for invasive breast cancer, but it is also associated with important harms, such as an increased likelihood of stroke, deep venous thrombosis, and gallbladder disease.

Neither combined estrogen and progestin therapy nor estrogen alone reduces the risk for coronary heart disease in postmenopausal women.

Balance of Harms and Benefits The chronic disease prevention benefits of combined estrogen and progestin do not outweigh the harms in most postmenopausal women. The chronic disease prevention benefits of estrogen are unlikely to outweigh the harms in most postmenopausal women who have had a hysterectomy.
Relevant USPSTF Recommendations The USPSTF has made recommendations on screening for osteoporosis and the use of preventive medications for breast cancer, as well as other relevant interventions for the primary or secondary prevention of chronic diseases in women, such as medications for cardiovascular disease and screening for coronary heart disease, high blood pressure, lipid disorders, colorectal cancer, breast cancer, and dementia. These recommendations are available at http://www.uspreventiveservicestaskforce.org/.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.

Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

AHRQ Publication No. 12-05168-EF-4
Current as of October 2012


Internet Citation:

Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: Clinical Summary of U.S. Preventive Services Task Force Recommendation. AHRQ Publication No. 12-05168-EF-4, October 2012. http://www.uspreventiveservicestaskforce.org/uspstf12/menohrt/menohrtsum.htm


 


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