09 Nov USPSTF: Hormone Therapy Not Recommended to Prevent Chronic Health Problems After Menopause
MedicalResearch.com Interview with:
James Stevermer, M.D., M.S.P.H.
Vice chair for clinical affairs
Professor of family and community medicine
University of Missouri
Medical director of MU Health Care Family Medicine–Callaway Physicians,
Dr. Stevermer joined the U.S. Preventive Service Task Force in January 2021.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As people get older, they are more at risk for many chronic conditions like heart disease, osteoporosis, cancer, and diabetes. It’s unclear how much menopause—which typically occurs around age 50—contributes to this risk. Although we all want to stay healthy as we age, the Task Force does not recommend that people who have already gone through menopause use hormone therapy to prevent chronic health problems.
MedicalResearch.com: What should readers take away from your report?
Response: What’s important to understand about this recommendation is that it is not for people who are considering hormone therapy to manage their symptoms of menopause, like hot flashes or night sweats. We encourage people experiencing those symptoms to talk with their clinician about what is right for them.
The important take away here is that people who have already gone through menopause should not use hormone therapy to prevent future chronic health problems. This applies to the use of either combined estrogen and progestin or estrogen alone. When we reviewed the latest evidence on the use of hormone therapy in postmenopausal people, we found that it may reduce the risk of some health conditions, but unfortunately it also can lead to serious harms like an increased risk of blood clots and stroke. Ultimately, the potential harms cancel out the benefits, which is why we are recommending against the use of hormone therapy for the prevention of chronic health issues.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: While the Task Force was reviewing the available research on this subject, we noticed a lack of studies about populations who experience socioeconomic barriers. People of color and people living in poverty are often at higher risk for certain chronic conditions like having a stroke or type 2 diabetes. As a result, it is important to understand whether hormone therapy might have a different balance of benefits and harms across different racial and ethnic groups. Also, more research is needed to understand whether health outcomes differ depending on the age a person started hormone therapy or when they went through menopause.
Similarly, more research is needed to understand whether different types of hormone therapy, or the length of time a person is on hormone therapy, changes the effects of treatment.
MedicalResearch.com: Is there anything else you would like to add?
Response: Patients should work with their clinicians and use evidence-based recommendations as guidance when considering how to stay healthy as they age.
While hormone therapy is not recommended, there are several other safe and effective ways for people to reduce their risk of chronic health problems, like maintaining a healthy diet and staying active. The Task Force has several recommendations on ways people can reduce their risk of chronic disease through preventive services like screening, as well as through behavioral counselling interventions. Fundamentally, people who want to help prevent chronic conditions as they age should avoid hormone therapy and explore other research-backed approaches instead.
US Preventive Services Task Force. Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: US Preventive Services Task Force Recommendation Statement. JAMA. 2022;328(17):1740–1746. doi:10.1001/jama.2022.18625
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