USPSTF: Hormone Therapy Not Advised for Primary Prevention of Chronic Conditions

TUESDAY, Nov. 1, 2022 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends against use of combined estrogen and progestin, or use of estrogen alone in those who have had a hysterectomy, for primary prevention of chronic conditions in postmenopausal persons. These recommendations form the basis of a final recommendation statement published in the Nov. 1 issue of the Journal of the American Medical Association.

Gerald Gartlehner, M.D., M.P.H., from RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, and colleagues updated the evidence on the benefits and risks of hormone therapy for reducing the risk for chronic conditions for the USPSTF. Data were included from 20 trials with 39,145 individuals and three cohort studies with 1,155,410 individuals. The researchers found that the risks for diabetes and fractures were lower among participants using estrogen only versus placebo, but risks were increased for gallbladder disease, stroke, venous thromboembolism, and urinary incontinence. Use of estrogen plus progestin versus placebo was associated with significantly lower risks for colorectal cancer, diabetes, and fractures but with increased risks of invasive breast cancer, gallbladder disease, stroke, venous thromboembolism, probable dementia, and urinary incontinence.

Based on these findings, the USPSTF concludes with moderate certainty that the use of combined estrogen and progestin has no net benefit for primary prevention of chronic conditions in postmenopausal persons with an intact uterus. For postmenopausal persons who have had a hysterectomy, the USPSTF concludes with moderate certainty that the use of estrogen alone has no net benefit for primary prevention of chronic conditions. The USPSTF recommends against use of combined estrogen and progestin and against use of estrogen alone in those who have had a hysterectomy for primary prevention of chronic conditions in postmenopausal persons (D recommendations).

"Importantly, this recommendation is only for people who are considering hormone therapy to prevent chronic conditions after going through menopause," a USPSTF member said in a statement.

Evidence Report

Final Recommendation Statement

Editorial