HRT not for primary prevention of chronic disease and probably causes urinary incontinence

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HRT not for primary prevention of chronic disease and probably causes urinary incontinence

The update from the US Preventive Services Task Force on hormone therapy (HRT) for the primary prevention of chronic conditions in postmenopausal women confirmed its view that HRT has some beneficial effects but also a substantial increase in risk of harms.1

  • Estrogen alone - a small reduction in diabetes, fractures, gallbladder disease and a small increase in stroke and venous thromboembolism (all less than 100 per 10,000 person-years), a large increase in urinary incontinence (1,261 cases per 10,000 person-years).
  • Estrogen plus progestin - a small reduction in colorectal cancer, diabetes and fractures but an increase in invasive breast cancer, probable dementia, stroke, venous thromboembolism (all less than 100 per 10,000 person-years) and a large increase in urinary incontinence of 876 cases per 10,000 person-years. The urinary incontinence issue has not received much attention.

The evidence of early initiation of HRT is inconclusive. Short-term use for flushes is still a safe use.

This Gem has been checked by Professor Ian Reid Department of Medicine University of Auckland.

Reference

  1. Hormone therapy for the primary prevention of chronic conditions in postmenopausal women. Evidence report and systematic review for the US Preventive Services Task Force. JAMA 2017  Click here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.



As published in NZ Doctor 25/04/2018