New study sounds warning on hormone replacement therapy

An analysis by a federal task force finds that hormone replacement therapy's risks may outweigh the benefits for women who are past menopause and healthy but hoping to ward off dementia, bone fractures or heart disease.

Women who are past menopause and healthy should not use hormone replacement therapy in hopes of warding off dementia, bone fractures or heart disease, says a new analysis by the government task force that weighs the risks and benefits of screening and other therapies aimed at preventing illness.

The recommendation by the U.S. Preventive Services Task Force does not necessarily apply to women who use hormone replacement therapy to reduce menopausal symptoms such as hot flashes, night sweats and vaginal dryness. The balance of harm and benefits for that use is expected to be addressed soon in a report by the federal Agency for Healthcare Research and Quality.

The latest recommendation, published Monday in the Annals of Internal Medicine, comes from an organization accustomed to controversy. In recent months, the task force has recommended against routine breast cancer screenings for most women younger than 50. It has also urged abandonment of the prostate-specific antigen, or PSA, test that has become a standard part of older men's yearly physicals.

Its latest recommendation could be a bit less controversial but is likely to have detractors among physicians who believe that the dangers of hormone replacement therapy for menopausal women have been overblown.

FOR THE RECORD: Hormone replacement therapy: An article in the May 29 LATExtra section about new guidance from the federal government about the risks and benefits of hormone replacement therapy for postmenopausal women contained several errors. The article said that the recommendation against such therapy to reduce the risk of dementia, bone fractures or heart disease had been published Monday in the Annals of Internal Medicine. The Annals report outlined the scientific evidence; the recommendation itself was published Tuesday on the website of the U.S. Preventive Services Task Force. The article should have noted that the recommendation is a draft that is open to public comment until June 26. Also, Dr. Kirsten Bibbins-Domingo was identified as the chairwoman of the task force and lead author of the Annals report; she is a member of the task force who served as topic lead for the group that examined the evidence, but the Annals report was written by others. Finally, the article said the task! force had recommended "in recent months" against routine mammograms for women in their 40s; that controversial recommendation was made in November 2009.

The recommendation is largely based on revised analyses of the landmark Women's Health Initiative, a 15-year study involving more than 160,000 women. It comes a decade after the study first linked hormone replacement therapy with higher rates of invasive breast cancer. Those initial findings prompted droves of women to abandon or avoid hormone therapy.