Evidence of significant adverse events led the U.S. Preventive Services Task Force to issue recommendations against using estrogen plus progestin in 2002 and estrogen alone in 2005 to prevent chronic conditions.
To update its recommendations, the Task Force conducted a systematic review of articles published since 2002 to determine the effectiveness of HRT in reducing risks for chronic conditions. The Task Force considered adverse events and the differences in outcomes among population subgroups.
Fifty-one articles met inclusion criteria for the review.
The Task Force found that both estrogen alone and estrogen plus progestin reduce the risk for fractures, but increase risk for stroke, thromboembolic events, gallbladder disease, and urinary incontinence.
Estrogen alone decreased risk for breast cancer.
Estrogen plus progestin increased risk for probable dementia and breast cancer.
The risk for breast cancer increased for women with prior oral contraceptive use, prior menopausal estrogen plus progestin therapy, or current smoking.
This evidence will inform an upcoming recommendation for menopausal hormone therapy.
Source: American College of Physicians, USA