Hormone Replacement Therapy After Menopause: What Women Need to Know

A government panel confirms that estrogen and progestin replacement therapy should be used sparingly, only to ward off the most intense symptoms of menopause, and not to protect against chronic disease.

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Confirming what a growing number of studies has shown, the U.S. Preventive Services Task Force (USPSTF), a government panel that periodically reviews the evidence on screening and other preventive treatments, recommended this week that postmenopausal women should not take hormone replacement therapy to prevent conditions such as heart disease, cancer or dementia.

Before 2002, doctors recommended that women use supplemental hormone treatments to restore levels of estrogen and progestin, which naturally wane during and after menopause. The thinking was that the hormone supplements would lower womens risk of cancer and heart disease: because women tend to experience heart attacks about a decade later than men, it was thought that womens hormones must provide some sort of protective effect.

(MORE: Making Sense of Hormone Therapy After Menopause)

But in 2002, the Womens Health Initiative (WHI), the first long-term study of hormone replacement therapy, which involved 160,000 women followed for 15 years, found little difference in heart disease rates among hormone users and non-users. In fact, the data showed slightly higher rates of heart disease and breast cancer among those who relied on hormone therapy.

Based on the data, thousands of women abandoned hormone therapy. Indeed, since the WHI findings were released, breast cancer and heart disease rates among postmenopausal women have dipped, possibly due to the drop in use of hormone therapy.

But over the past decade, scientists have continued to study the long-term effects of supplemental hormone treatments, including the use of estrogen alone, on womens health outcomes. Some data have suggested that some postmenopausal women taking hormone therapy may reduce their risks of bone fractures, dementia and even heart disease.

If the back-and-forth seems confusing, thats because it is, thanks to the piecemeal way in which study results, each focused on a specific outcome such as osteoporosis or heart disease have been released. So the government panel reviewed all the latest gold-standard evidence and weighed the potential benefits of hormone therapy to its risks in context

(MORE: U.S. Panel Recommends Delaying Regular Mammograms Until Age 50)

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Hormone Replacement Therapy After Menopause: What Women Need to Know