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U.S. Preventive Services Task Force Recommends Against the Routine Use of Combined Estrogen, Progestin in Postmenopausal Women

May 25, 2005 -- WASHINGTON -- The U.S. Preventive Services Task Force (USPSTF) recommends against the routine use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women.

The USPSTF found good evidence that the use of combined estrogen and progestin results in both benefits and harms. Benefits include reduced risk for fracture (good evidence) and colorectal cancer (fair evidence). Combined estrogen and progestin has no beneficial effect on coronary heart disease and may even pose an increased risk (good evidence). Other harms include increased risk for breast cancer (good evidence), venous thromboembolism (good evidence), stroke (fair evidence), cholecystitis (fair evidence), dementia (fair evidence), and lower global cognitive function (fair evidence).

Because of insufficient evidence, the USPSTF could not assess the effects of combined estrogen and progestin on the incidence of ovarian cancer, mortality from breast cancer or coronary heart disease, or all-cause mortality. The USPSTF concluded that the harmful effects of combined estrogen and progestin are likely to exceed the chronic disease prevention benefits in most women.

The USPSTF recommends against the routine use of unopposed estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy.

The USPSTF found good evidence that the use of unopposed estrogen results in both benefits and harms. The benefits include reduced risk for fracture (good evidence). Harms include increased risk for venous thromboembolism (fair evidence), stroke (fair evidence), dementia (fair evidence), and lower global cognitive functioning (fair evidence). There is fair evidence that unopposed estrogen has no beneficial effect on coronary heart disease.

Because of insufficient evidence, the USPSTF could not assess the effects of unopposed estrogen on the incidence of breast cancer, ovarian cancer, or colorectal cancer as well as breast cancer mortality or all-cause mortality. The USPSTF concluded that the harmful effects of unopposed estrogen are likely to exceed the chronic disease prevention benefits in most women.

Source: Agency for Healthcare Research and Quality

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