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Word of the Day

USPSTF recommends against menopause hormone tx to prevent chronic conditions

Clinical Question:
Should hormone replacement be used in postmenopausal women to prevent the development of chronic conditions?

Bottom Line:
The United States Preventive Services Task Force continues to recommend against using estrogen/progestin treatment in postmenopausal women to try to prevent coronary heart disease, dementia, hip fracture, breast cancer, or other conditions. This is a D recommendation (no net benefit or harms outweigh benefit). The recommendation does not address the use of hormone replacement to treat postmenopausal symptoms and does not apply to women younger than 50 years with surgical menopause. (LOE = 5)

Reference:
Moyer VA; on behalf of the U.S. Preventive Services Task Force. Menopausal hormone therapy for the primary prevention of chronic conditions: U.S. Preventive Services Task Force Recommendations statement. Ann Intern Med 2013;158:47-54.  [PMID:23090711]

Study Design:
Practice Guideline

Funding:
Government

Setting:
Various (guideline)

Synopsis:
This guideline pertains to women considering postmenopausal hormone therapy to prevent chronic conditions and does not apply to women desiring treatment of postmenopausal symptoms or to women younger than 50 years with surgical menopause. The task force concludes with high certainty that the benefits do not outweigh the harms in most postmenopausal women. Although hormone replacement therapy can decrease fractures, there is an accompanying increase in other conditions such as stroke, thromboembolism, and gall bladder disease. Hormone replacement does not decrease the risk of coronary heart disease. The recommendation applies to postmenopausal women with or without hysterectomy.

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