Menopausal hormone therapy for primary prevention: why the USPSTF is wrong

Climacteric. 2017 Oct;20(5):402-413. doi: 10.1080/13697137.2017.1362156. Epub 2017 Aug 14.


The US Preventive Services Task Force (USPSTF) Draft Recommendation statement on Menopausal Hormone Therapy: Primary Prevention for Chronic Diseases, released in May 2017, perpetuates a major disconnect between the primary population affected, women within roughly 10 years of menopause, and the data cited. Furthermore, major elements of the evidence relied upon have been misinterpreted or misstated, particularly in regard to coronary heart disease and breast cancer, for which there is no statistically significant evidence of harm. As currently drafted, the recommendations reiterate the USPSTF statements of 2012, 2005 and 2002, and will perpetuate egregious harm to the public health. In an attempt to avoid that outcome and to facilitate a return to rational discourse regarding menopausal hormone therapy, an ad hoc group of experts in menopausal health submitted this comprehensive response to the USPSTF.

Keywords: Menopause; breast cancer; cardiovascular disease; chronic disease prevention; fragility fracture; hormone replacement therapy; osteoporosis.

MeSH terms

  • Breast Neoplasms / epidemiology
  • Cardiovascular Diseases / epidemiology
  • Chronic Disease / prevention & control
  • Coronary Disease / epidemiology
  • Estrogen Replacement Therapy* / adverse effects
  • Estrogen Replacement Therapy* / methods
  • Estrogens, Conjugated (USP)
  • Female
  • Humans
  • Medroxyprogesterone Acetate
  • Menopause*
  • Middle Aged
  • Postmenopause
  • Primary Prevention* / organization & administration
  • Risk Factors
  • Time Factors
  • United States
  • Women's Health


  • Estrogens, Conjugated (USP)
  • Medroxyprogesterone Acetate