Public Release: 

Task force issues caution on combined hormone therapy

American College of Physicians

The U.S. Preventive Services Task Force today recommended against the use of combined estrogen and progestin therapy for preventing cardiovascular disease and other chronic conditions in postmenopausal women. The recommendations are posted on the Web sites of Annals of Internal Medicine (http://www.acponline.org/journals/annals/hrt.htm) and the Agency for Healthcare Research and Quality (http://www.ahrq.gov/clinic/3rduspstf/hrt/hrtrr.htm) and will be published in the November 19 issue of the journal.

The Task Force, an independent panel of private-sector experts in prevention and primary care sponsored by the Agency for Healthcare Research and Quality, found evidence for both benefits and harms of combined estrogen and progestin therapy, one of the most commonly prescribed hormone regimens. However, it concluded that harmful effects of the combined therapy are likely to exceed the chronic-disease prevention benefits for most women.

The Task Force further concluded that the evidence is insufficient to recommend for or against the use of estrogen alone for prevention of chronic conditions in postmenopausal women who have had hysterectomies. A study of estrogen therapy in these women is continuing as part of the National Institutes of Health's Women's Health Initiative.

Estrogen alone, or estrogen and progestin together, are commonly referred to as hormone therapy or hormone replacement therapy. An estimated 14 million American women take hormone therapy to help relieve hot flashes and other menopausal symptoms as well as to prevent chronic conditions such as heart disease, the leading cause of death among U.S. women. The use of hormone therapy to treat hot flashes or other symptoms of menopause was not evaluated by the Task Force. The Task Force concluded that women considering starting or continuing hormone therapy to relieve menopausal symptoms should discuss their individual risks and personal preferences with their clinicians.

The Task Force based its conclusions on a report from a team led by Heidi Nelson, MD, MPH, and Linda Humphrey, MD, MPH, from AHRQ's Evidence-based Practice Center at Oregon Health & Science University in Portland. These reports were published in the August 20 Annals of Internal Medicine and the August 21 Journal of the American Medical Association.

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