Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: US Preventive Services Task Force Recommendation Statement.
Level 1 - systematic review of randomized trials
USPSTF clinical practice guideline based on a commissioned systematic review of randomized controlled trials
PubMed 36318127 · doi:10.1001/jama.2022.18625
What was done
The US Preventive Services Task Force (USPSTF) updated its 2017 recommendation by commissioning a systematic review to evaluate the benefits and harms of systemic (oral or transdermal) hormone therapy for the primary prevention of chronic conditions in asymptomatic postmenopausal persons, including whether outcomes differ by age or timing since menopause.
What was found
The abstract reports no numerical risk ratios or effect sizes. The USPSTF concluded with moderate certainty that neither combined estrogen and progestin (for individuals with an intact uterus) nor estrogen alone (for individuals post-hysterectomy) provides a net benefit for the primary prevention of chronic conditions, resulting in a "D" recommendation against use for this purpose.
Why it matters
This guideline reaffirms that systemic hormone therapy should not be prescribed to asymptomatic postmenopausal individuals solely to prevent long-term chronic conditions such as cardiovascular disease, cancer, or osteoporosis.
Limits
The abstract provides no quantitative data, event rates, or details on individual trial characteristics. This recommendation applies exclusively to primary prevention in asymptomatic postmenopausal persons and does not address the use of hormone therapy for managing menopausal symptoms such as vasomotor dysfunction.