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February 2018

Evidence for Postmenopausal Hormone Therapy to Prevent Chronic Conditions: Success, Failure, and Lessons Learned

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2San Francisco VA Medical Center, San Francisco, California
  • 3Deputy Editor, JAMA Internal Medicine
JAMA Intern Med. 2018;178(2):185-186. doi:10.1001/jamainternmed.2017.7861

In the current issue of JAMA, the US Preventive Services Task Force reiterates and updates their recommendation that asymptomatic postmenopausal women should not take hormone therapy (HT) to prevent chronic conditions.1,2

Twenty-five years ago, I coauthored a systematic review of the literature3 that supported guidelines from the American College of Physicians4 for counseling asymptomatic postmenopausal women about preventive HT. At the time, there were more than 30 studies supporting the benefits of HT for prevention of osteoporotic fractures and coronary disease events. The guidelines suggested that HT for prevention of disease should be considered by all women and recommended for women at risk for coronary heart disease.4 However, all of the studies included in the systematic review were observational. No randomized trials with clinical outcomes had been conducted.

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