Prevention check
Should I take hormone therapy after menopause to prevent disease?
Observational studies once suggested that hormone therapy after menopause might protect the heart, but large trials did not show that. The US Preventive Services Task Force weighed the trial evidence on preventing chronic conditions. Check what it says for you.
About you
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What you will see
What the USPSTF says about hormone therapy to prevent chronic conditions for you.
Educational only, not medical advice. Do not stop a prescribed medicine without talking to your clinician.
Source
US Preventive Services Task Force, November 2022 recommendation on hormone therapy for the primary prevention of chronic conditions in postmenopausal persons.
Validated in
Postmenopausal people without symptoms who are considering systemic (oral or skin patch) hormone therapy to prevent chronic conditions.
Limits
It does not cover hormone therapy for menopausal symptoms, premature or surgical menopause, or local (vaginal) products.
What the USPSTF recommends
| Who | Recommendation | Grade |
|---|---|---|
| Postmenopausal people | Against combined estrogen and progestin to prevent chronic conditions | D |
| Postmenopausal people who have had a hysterectomy | Against estrogen alone to prevent chronic conditions | D |
The USPSTF concluded with moderate certainty that neither combination has a net benefit for preventing chronic conditions (USPSTF 2022). The advice does not cover hormone therapy for menopausal symptoms such as hot flashes or vaginal dryness, or people with premature menopause (primary ovarian insufficiency) or surgical menopause (USPSTF 2022). FDA-approved uses of hormone therapy after menopause are limited to treating menopausal symptoms and preventing postmenopausal osteoporosis (USPSTF 2022).
Benefits and harms in the trials
The largest trial was the Women's Health Initiative (WHI), which enrolled people aged 50 to 79 (average age 63) and tested oral conjugated equine estrogen, with or without medroxyprogesterone acetate, against placebo (USPSTF 2022).
| Outcome | Estrogen plus progestin | Estrogen alone (after hysterectomy) |
|---|---|---|
| Fractures | Fewer: 8.7% vs 10.9% (pooled trials) | Fewer: 1.53% vs 2.14% a year |
| Diabetes | Fewer new cases | Fewer: 1.34% vs 1.55% a year |
| Coronary heart disease | No benefit | No benefit |
| Breast cancer | More invasive breast cancer: 2.4% vs 1.9% | Less invasive breast cancer over long-term follow-up |
| Colorectal cancer | Fewer: 0.59% vs 0.93% | No significant difference |
| Stroke | More: 1.9% vs 1.3% | More: 3.2% vs 2.4% |
| Blood clots in the veins | More: 1.96% vs 0.94% | More deep vein clots: 1.6% vs 1.0% |
| Probable dementia | More: 1.8% vs 0.9% | No significant increase |
| Gallbladder disease | More | More |
| Urinary incontinence | More | More |
Figures compare the hormone group with placebo, from the USPSTF evidence summary (USPSTF 2022). Weighing all of these together, the USPSTF judged the harms of both options as moderate and found no net benefit (USPSTF 2022).
Common questions
Does it matter how soon after menopause I start?
It has been suggested that benefits and harms differ by age or by time since menopause, but the USPSTF found the evidence for this limited. For most outcomes the WHI found no differences by these factors (USPSTF 2022).
What about other types, doses or patches?
The USPSTF considered systemic hormone therapy taken by mouth or through the skin. Evidence on types, doses and delivery methods other than those used in the WHI was limited (USPSTF 2022).
What does the USPSTF recommend instead?
It points to its other recommendations, including blood pressure, diabetes, osteoporosis, breast cancer and colorectal cancer screening, and diet and activity counseling for heart health (USPSTF 2022).
Also see the osteoporosis screening check, the breast cancer screening check, the diet and exercise counseling check, the vitamin D and calcium check and all screening tests by age.
Sources
- US Preventive Services Task Force. Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: US Preventive Services Task Force Recommendation Statement. JAMA. 2022;328(17):1740. www.uspreventiveservicestaskforce.org/uspstf/recommendation/menopausal-hormone-therapy-preventive-medication
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-29. Spotted an error? See About.