Task Force: HRT OK for Some Women

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Hormone replacement: yes or no? That seems to be the evergreen question when it comes to this therapy, and the answer is not as straightforward as one would hope. In its latest draft guidelines, the U.S. Preventive Services Task Force (USPSTF) analyzed recent data from the landmark Women s Health Initiative (WHI) study and is recommending against the use of estrogen and progestin for preventing fractures, dementia, cancer, and other chronic disease in postmenopausal women. It s important to note, however, that the new guidelines do not apply to perimenopausal or menopausal women who frequently use hormones to treat hot flashes and other uncomfortable symptoms. Further, the Task Force recommendations are largely based on data from women who used hormone replacement therapy (HRT) much later after menopause and continued on it for a longer time than is currently prescribed.

And though the WHI study was halted prematurely in 2002, due to concern that HRT increased the risk of breast cancer, heart disease, and stroke, such effects were observed mostly in women who began the treatment while in their 60s and 70s and used it for a prolonged period of time. In fact, recent research has found that women taking estrogen-only therapy (which is restricted to just those patients who have undergone a hysterectomy) may actually have a decreased risk of breast cancer.

Unlike certain other Task Force guidelines, including their recent recommendation against PSA testing, the latest conclusions on HRT do not differ from previous recommendations.