Newsflash! U.S. Preventive Services Task Force Weighs in on HRT

Posted by Liz on Jun 4, 2012 in estrogen, HRT | 2 comments

Just like the Energizer bunny. HRT and bad news. When are women and practitioners going to believe the data and stop trying to find the silver lining?

This month’s news is from the U.S. Preventive Services Task Force, who issued a recent update of the evidence for or against the use of hormone replacement for menopausal symptoms; that update appears in the online edition of Annals of Internal Medicine.

Rather than bore you with the details, I’m going to cut to the chase and get to the heart of their findings:

• Estrogen plus progestin or estrogen alone provides significant protection against hip and vertebral fractures that result from osteoporosis and aging.
• Contrary to initial results from the Women’s Health Initiative study, use of estrogen plus progestin significantly increases the risk for invasive breast cancer.  Estrogen alone offers some protection against invasive breast cancer.
• Updated analyses also demonstrate that combination HRT also significantly increases risk for stroke, blood clot events, death from lung cancer, gallbladder disease and urinary incontinence.
• Estrogen alone increases the risk for stroke, blood clot events, gallbladder disease and urinary incontinence.

One of the primary arguments that proponents of hormone therapy have used consistently is that these data are restricted to women who are older and are not applicable to women who are perimenopausal or in the earliest stages of menopause. And yet, a variety of medical organizations caution against using HRT as a chronic disease prevention strategy, including the Canadian Task Force on Preventive Health Care, American Heart Association and American College of Obstetricians and Gynecologists.

Even the FDA posits that if you are going to use hormone replacement, you should use it in the short-term and only for ameliorating menopausal symptoms or preventing bone loss. And yet, if you read through four years of Flashfree or click on the tag cloud, you’ll find a number of alternative strategies to offer relief without the slippery risk slope.

What more can I say? Be informed so that you can make informed decisions. If a few less hot flashes or night sweats in the short term means a potential road of illness in the long-term, the benefit-risk ratio may not be worth it. Then again? Only you can decide.