The United States Prevention Services Task Force (USPTF) has updated its 2005 recommendations on the use of postmenopausal hormones as a strategy to prevent chronic conditions in healthy women [1]. The USPSTF commissioned a review of the literature to update evidence about the benefits and harms of using menopausal hormone therapy to prevent chronic conditions, as well as whether the benefits and harms of hormone therapy differ by population subgroups defined by age, the presence of comorbid medical conditions, and the type, dose, and method of hormonal delivery.
This recommendation applies to postmenopausal women who are considering hormone therapy for the primary prevention of chronic medical conditions. It does not apply to women who are considering hormone therapy for the management of menopausal symptoms, such as hot flushes or vaginal dryness. It also does not apply to women younger than 50 years who have had surgical menopause.
The USPSTF recommends against the use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women. The USPSTF recommends against the use of estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy. Recommendations are based on the evidence of both the benefits and harms of the service and an assessment of the balance.
The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision-making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms.
Author(s)
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Amos Pines
Department of Medicine T, Ichilov Hospital, Tel-Aviv, Israel
Citations
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Moyer VA. Menopausal hormone therapy for the primary prevention of chronic conditions. U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2012 Oct 23. Free for downloading at
http://annals.org/article.aspx?articleid=1384872 -
Nelson HD, Walker M, Zakher B, Mitchell J. Menopausal hormone therapy for the primary prevention of chronic conditions: a systematic review to update the U.S. Preventive Services Task Force recommendations. Ann Intern Med 2012;157:104-1.
http://www.ncbi.nlm.nih.gov/pubmed/22786830
