Hormone Therapy Risks Outweigh Benefits

An elderly woman walks in San Jose on May 12. (RODRIGO ARANGUA/AFP/GettyImages)

Women past menopause should not take hormone replacement therapy (HRT) due to increased risk of disease, says a recent statement by a panel of preventive medicine experts.

The U.S. Preventive Services Task Force (USPSTF) released a draft recommendation statement May 29 that found the potential harm of HRT, and its use of estrogen and progestin, greater than the potential benefit. The group suggests that HRT not only fails to protect against heart disease, it actually increases the risk of that and other ills.

The task force recommends against the use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women, according to the draft statement.

Osteoporosis, a disease that causes loss of bone density and bone tissue, can be a debilitating, painful condition that impacts menopausal women over 50. Hormones were once touted as a fountain of youth, meant to keep bones strong, skin supple, brains smart, and hearts healthy.

Menopausal women over 50 have a lower risk of hip fractures and other fractures if they take hormones. The USPSTF found convincing evidence that estrogen and progestin therapy is of moderate benefit in reducing the risk for fractures in postmenopausal women, the USPSTF stated.

But according to the draft recommendation, the group found adequate evidence that its use is also associated with moderate harms, including an increase in the risk for stroke, dementia, gallbladder disease, and urinary incontinence. There is convincing evidence of a small increase in the incidence of invasive breast cancer, and adequate evidence of a small increase in breast cancer deaths.

The advice does not apply to women under 50. For them, estrogen alone can reduce the risk of breast cancer, although it is not yet understood why that is the case.

The task force used data from a Womens Health Initiative (WHI) randomized, controlled trial, involving participants of an average age of 64well past menopause.

Hormone replacement therapy had already fallen out of favor for post-menopausal women over evidence that it increases the risk of breast cancer.

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Hormone Therapy Risks Outweigh Benefits