HRT, women and heart disease: facts about prevention

In 1996, the U.S. Preventive Services Task Force (USPSTF) recommended counseling all perimenopausal and postmenopausal women about the potential benefits and harms of HRT. They determined that there was insufficient evidence to recommend for or against HRT for all women, but thought that individual decisions should be based on patient risk factors, an understanding of the probable benefits (for example, the prevention of myocardial infraction or fracture) and harms (for example, endometrial cancer with unopposed estrogen or breast cancer), and personal preferences. New recommendations were posted on October 23, 2002, and now the USPSTF recommends against the routine use of estrogen and progestin for the prevention of chronic conditions in postmenopausal women. The USPSTF found fair to good evidence that the combination of estrogen and progestin has both benefits and harms.