Hormone therapy 'not recommended'

Hot flashes are a symptom of menopause for which some women may seek treatment with hormone replacement therapy.

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(CNN) -- The task force that sparked controversy with its breast cancer screening recommendations a few years ago -- and PSA prostate-cancer screening pronouncements last week -- is weighing in on hormone replacement therapy. But this time the U.S. Preventive Services Task Force recommendations are remarkable for their lack of controversy.

The group says menopausal women should not use hormone therapy -- estrogen either alone or combined with progestin -- primarily to prevent chronic disease.

"In the face of pretty good evidence, the balance of potential benefits and potential harms leads us not to recommend the use of these therapies," said Dr. Kirsten Bibbins-Domingo, a task force member.

The proposed recommendations do not apply to women younger than 50 who have undergone surgical menopause or who are taking hormone therapy to manage menopausal symptoms such as hot flashes, according to the panel.

"No shock there," said Dr. Carolyn Crandall, a professor of medicine at the David Geffen School of Medicine at UCLA. "I don't think the recommendations are surprising at all."

The question used to shape the draft recommendations, which were posted online Tuesday, is whether hormone therapy should be used by menopausal women to prevent a hypothetical future health event such as heart disease or cognitive decline, Bibbins-Domingo said.

"These are women who don't have disease, who don't have menopause symptoms, who are using the therapies only to prevent something that might happen in the future," said Bibbins-Domingo, an associate professor of medicine, epidemiology and biostatistics at the University of California, San Francisco. "There is no evidence that the therapies would prevent those conditions."

Years ago, in addition to providing relief for menopause symptoms, hormone therapy was thought to offer protection against cardiovascular problems, osteoporosis and dementia, so doctors routinely prescribed it to otherwise healthy women. That practice fell out of favor about 10 years ago when a large clinical trial -- the Women's Health Initiative -- designed to confirm these hypotheses was halted early.

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Hormone therapy 'not recommended'