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Terapia hormonal para la prevención primaria de enfermedades crónicas en personas posmenopáusicas: Declaración de
, Carol M Mangione1, Michael J Barry2
1University of California, Los Angeles.
JAMA
|November 1, 2022
Resumen
La terapia hormonal para la prevención de enfermedades crónicas en personas posmenopáusicas no ofrece ningún beneficio neto. El Grupo de Trabajo de Servicios Preventivos de los Estados Unidos recomienda no usar estrógeno o terapia hormonal combinada para este propósito.
Área de la Ciencia:
- Salud Reproductiva
- La medicina preventiva
- Endocrinología
Sus antecedentes:
- La menopausia, el cese de la menstruación, significa una transición donde aumenta el riesgo de enfermedades crónicas.
- Las personas posmenopáusicas enfrentan un mayor riesgo de enfermedades cardiovasculares, cáncer y osteoporosis.
- A menudo se considera la terapia hormonal para prevenir estas afecciones crónicas en mujeres posmenopáusicas.
Objetivo del estudio:
- Evaluar los beneficios y los daños de la terapia hormonal sistémica para la prevención de enfermedades crónicas en personas posmenopáusicas.
- Actualizar la recomendación de 2017 del Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF) sobre terapia hormonal.
- Para determinar si los resultados varían según la edad o el momento de la intervención de la terapia hormonal.
Principales métodos:
- Una revisión sistemática fue encargada por el USPSTF.
- La revisión evaluó la terapia hormonal sistémica (oral o transdérmica) para la prevención primaria de las enfermedades crónicas.
- En la revisión se consideraron individuos posmenopáusicos asintomáticos que estaban considerando la terapia hormonal.
Principales resultados:
- La terapia combinada de estrógeno y progestina en personas posmenopáusicas con útero intacto no mostró ningún beneficio neto.
- La terapia con estrógeno en solitario en personas posmenopáusicas que han tenido una histerectomía tampoco mostró ningún beneficio neto.
- Estos hallazgos se mantienen con cierta certeza.
Conclusiones:
- El USPSTF recomienda no usar estrógeno y progestina combinados para la prevención primaria de enfermedades crónicas en personas posmenopáusicas.
- El USPSTF también recomienda no usar estrógeno solo para la prevención primaria de enfermedades crónicas en personas posmenopáusicas con antecedentes de histerectomía.
- Estas son recomendaciones "D", lo que indica una fuerte oposición basada en la evidencia de que no hay beneficio neto.
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