Postmenopausal Women Should Not Use Hormone Therapies

To prevent chronic medical conditions postmenopausal women should not use the hormone treatments, because the risk of significant side effects outweighs the unclear evidence of an advantage, according to a government-backed panel of specialists. Most chronic conditions – coronary heart disease, dementia, stroke, fractures, and breast cancer, for example – are more common with increasing age, however, there is little evidence to connect them with hormonal changes related with menopause.

Still, hormone treatment was once commonly prescribed to prevent these conditions, until outcomes from the large Women’s Health Initiative (WHI) study revealed serious adverse health impacts in postmenopausal women who received menopausal hormone treatment.

The U.S. Preventive Services Task Force (USPSTF) based its new recommendations with respect to a review of confirmation from 18 studies involving more than 40,000 ladies, which demonstrated some possible beneficial impacts of hormone treatment but significantly increased risks of ill effects.

Rather than hormone treatment, the USPSTF has suggested, in other statements, a healthy diet and physical activity for the prevention of cardiovascular disease; daily low-dose aspirin to reduce the risk of colon cancer and cardiovascular disease in certain women; and drugs like tamoxifen and raloxifene to reduce the risk of breast cancer in certain high- risk women.

Dr. Maureen Phipps of the Warren Alpert Medical School of Brown University, Providence, Rhode Island, who chairs the Task Force, told Reuters Health by email that, ” It is important to note that this recommendation is not focused on the use of hormone treatment to manage menopausal symptoms, such as hot flashes or night sweats”.

When she and her associates were enlisting ladies to take an interest in the WHI trials in the 1990s, the examination was dubious, Dr. Cora E. Lewis from the University of Alabama at Birmingham School of Medicine told Reuters Health by email.

Lewis said, “Some in the medicinal community were convinced to the point that postmenopausal hormone treatment would be beneficial for some conditions, including prevention of cardiovascular disease, that it was unethical to perform out a trial in which women could be randomized to placebo”.

“We asked women to be the part of the answer and participate, and a large number of them did. We are deeply grateful to them”. “Maybe new both for physicians and for women is the WHI information demonstrating that, based on 18 years of development, all-cause death rates did not vary significantly for the hormone and placebo groups.

Therefore, menopausal hormone treatment, used as a part of this trial for five to seven years, was not related with a risk of long-term all-cause, cardiovascular, or cancer mortality “, Dr. Nanette K. Wenger from Emory University School of Medicine, Atlanta, Georgia, told Reuters Health by email.

Lewis and Wenger both noted, this should to reassuring to women who require short-term hormone treatment to manage menopausal symptoms. Concerning cardiovascular prevention, Wenger stated, “The American Heart Association’s ‘Life’s Simple 7,’ addressing initially lifestyle and, if necessary, medicines to prevent cardiovascular risk, is the broadly accepted preventive approach.”

The full USPSTF recommendation statement was published in The Journal of the American Medical Association, alongside a separate report documenting the evidence supporting the recommendations.


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