Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: Systematic Review to Update the 2002 and 2005 U.S. Preventive Services ... Recommendations: Evidence Synthesis Number 93
Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: Systematic Review to Update the 2002 and 2005 U.S. Preventive Services ... Recommendations: Evidence Synthesis Number 93
Overview
This systematic evidence review is an update for the U.S. Preventive Services Task Force (USPSTF) recommendations on use of menopausal hormone therapy for postmenopausal women to prevent chronic health conditions such as cardiovascular disease, types of cancer, and osteoporotic fractures. Use of menopausal hormone therapy for treatment of menopausal symptoms, such as vasomotor hot flashes or urogenital atrophy, or for other indications is outside the scope of this review. Menopausal hormone therapy includes use of various forms, doses, and regimens of estrogen with or without progestin. Estrogen combined with progestin is used by women who have not had previous hysterectomies to prevent endometrial proliferation and endometrial cancer, whereas women with previous hysterectomies use estrogen only. In 2002, the USPSTF recommended against the routine use of combined estrogen and progestin hormone therapy for the prevention of chronic conditions in postmenopausal women who have not had hysterectomies because the harmful effects were likely to exceed the chronic disease prevention benefits in most women (D recommendation). Based on the results of systematic reviews3-11 and early findings of the Women's Health Initiative (WHI) trial of estrogen plus progestin, the USPSTF found good evidence that combined hormone therapy results in both benefits and harms. Benefits included reduced risk for fracture (good evidence) and colorectal cancer (fair evidence). Combined estrogen and progestin had no beneficial effect on coronary heart disease and suggested an increased risk (good evidence). Other harms included increased risk for breast cancer (good evidence), venous thromboembolism (good evidence), stroke (fair evidence), cholecystitis (fair evidence), dementia (fair evidence), and lower global cognitive function (fair evidence). Because of insufficient evidence, the USPSTF could not assess effects on the incidence of ovarian cancer, mortality from breast cancer or coronary heart disease, or all-cause mortality.In 2005, the USPSTF recommended against the routine use of unopposed estrogen for the prevention of chronic conditions in postmenopausal women who have had previous hysterectomies based on results of the WHI trial of estrogen only in women with hysterectomies (D recommendation). The USPSTF found good evidence that the use of unopposed estrogen resulted in both benefits and harms. The benefits included reduced risk for fracture (good evidence), and harms included increased risk for venous thromboembolism (fair evidence), stroke (fair evidence), dementia (fair evidence), and lower global cognitive function (fair evidence). There was fair evidence that unopposed estrogen had no beneficial effect on coronary heart disease. The USPSTF could not assess the effects of unopposed estrogen on the incidence of breast cancer, ovarian cancer, or colorectal cancer, as well as breast cancer mortality or all-cause mortality. A standard protocol was developed and followed for this review. Based on evidence from the previous review and using the methods of the USPSTF, USPSTF members and Agency for Healthcare Research and Quality (AHRQ) scientific staff determined the key questions for this update. Investigators created an analytic framework incorporating the key questions and outlining the patient populations, interventions, outcomes, and harms of menopausal hormone therapy. Key questions include: 1. What are the benefits of menopausal hormone therapy when used to prevent chronic conditions? 2. What are the harms of menopausal hormone therapy when used to prevent chronic conditions? 3. Do benefits and harms differ by subgroups? Subgroups include women with premature menopause; surgical menopause; age of use; types, doses, and modes of delivery of hormones; and presence of comorbidities.Description
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- Used - Good: All pages and cover are intact (including the dust cover, if applicable). Spine may show signs of wear. Pages may include limited notes and highlighting. May include "From the library of" labels. Shrink wrap, dust covers, or boxed set case may be missing. Item may be missing bundled media.
- Used - Acceptable: All pages and the cover are intact, but shrink wrap, dust covers, or boxed set case may be missing. Pages may include limited notes, highlighting, or minor water damage but the text is readable. Item may but the dust cover may be missing. Pages may include limited notes and highlighting, but the text cannot be obscured or unreadable.
Note: Some electronic material access codes are valid only for one user. For this reason, used books, including books listed in the Used – Like New condition, may not come with functional electronic material access codes.
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Estimated delivery times:
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- Expedited Shipping: 3-5 business days
Shipping method varies depending on what is being shipped.
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If you have any questions regarding shipping or want to know about the status of an order, please contact us or email to support@stevensbooks.com.
Returns & Refunds
You may return most items within 30 days of delivery for a full refund.
To be eligible for a return, your item must be unused and in the same condition that you received it. It must also be in the original packaging.
Several types of goods are exempt from being returned. Perishable goods such as food, flowers, newspapers or magazines cannot be returned. We also do not accept products that are intimate or sanitary goods, hazardous materials, or flammable liquids or gases.
Additional non-returnable items:
- Gift cards
- Downloadable software products
- Some health and personal care items
To complete your return, we require a tracking number, which shows the items which you already returned to us.
There are certain situations where only partial refunds are granted (if applicable)
- Book with obvious signs of use
- CD, DVD, VHS tape, software, video game, cassette tape, or vinyl record that has been opened
- Any item not in its original condition, is damaged or missing parts for reasons not due to our error
- Any item that is returned more than 30 days after delivery
Items returned to us as a result of our error will receive a full refund,some returns may be subject to a restocking fee of 7% of the total item price, please contact a customer care team member to see if your return is subject. Returns that arrived on time and were as described are subject to a restocking fee.
Items returned to us that were not the result of our error, including items returned to us due to an invalid or incomplete address, will be refunded the original item price less our standard restocking fees.
If the item is returned to us for any of the following reasons, a 15% restocking fee will be applied to your refund total and you will be asked to pay for return shipping:
- Item(s) no longer needed or wanted.
- Item(s) returned to us due to an invalid or incomplete address.
- Item(s) returned to us that were not a result of our error.
You should expect to receive your refund within four weeks of giving your package to the return shipper, however, in many cases you will receive a refund more quickly. This time period includes the transit time for us to receive your return from the shipper (5 to 10 business days), the time it takes us to process your return once we receive it (3 to 5 business days), and the time it takes your bank to process our refund request (5 to 10 business days).
If you need to return an item, please Contact Us with your order number and details about the product you would like to return. We will respond quickly with instructions for how to return items from your order.
Shipping Cost
We'll pay the return shipping costs if the return is a result of our error (you received an incorrect or defective item, etc.). In other cases, you will be responsible for paying for your own shipping costs for returning your item. Shipping costs are non-refundable. If you receive a refund, the cost of return shipping will be deducted from your refund.
Depending on where you live, the time it may take for your exchanged product to reach you, may vary.
If you are shipping an item over $75, you should consider using a trackable shipping service or purchasing shipping insurance. We don’t guarantee that we will receive your returned item.
Overview
This systematic evidence review is an update for the U.S. Preventive Services Task Force (USPSTF) recommendations on use of menopausal hormone therapy for postmenopausal women to prevent chronic health conditions such as cardiovascular disease, types of cancer, and osteoporotic fractures. Use of menopausal hormone therapy for treatment of menopausal symptoms, such as vasomotor hot flashes or urogenital atrophy, or for other indications is outside the scope of this review. Menopausal hormone therapy includes use of various forms, doses, and regimens of estrogen with or without progestin. Estrogen combined with progestin is used by women who have not had previous hysterectomies to prevent endometrial proliferation and endometrial cancer, whereas women with previous hysterectomies use estrogen only. In 2002, the USPSTF recommended against the routine use of combined estrogen and progestin hormone therapy for the prevention of chronic conditions in postmenopausal women who have not had hysterectomies because the harmful effects were likely to exceed the chronic disease prevention benefits in most women (D recommendation). Based on the results of systematic reviews3-11 and early findings of the Women's Health Initiative (WHI) trial of estrogen plus progestin, the USPSTF found good evidence that combined hormone therapy results in both benefits and harms. Benefits included reduced risk for fracture (good evidence) and colorectal cancer (fair evidence). Combined estrogen and progestin had no beneficial effect on coronary heart disease and suggested an increased risk (good evidence). Other harms included increased risk for breast cancer (good evidence), venous thromboembolism (good evidence), stroke (fair evidence), cholecystitis (fair evidence), dementia (fair evidence), and lower global cognitive function (fair evidence). Because of insufficient evidence, the USPSTF could not assess effects on the incidence of ovarian cancer, mortality from breast cancer or coronary heart disease, or all-cause mortality.In 2005, the USPSTF recommended against the routine use of unopposed estrogen for the prevention of chronic conditions in postmenopausal women who have had previous hysterectomies based on results of the WHI trial of estrogen only in women with hysterectomies (D recommendation). The USPSTF found good evidence that the use of unopposed estrogen resulted in both benefits and harms. The benefits included reduced risk for fracture (good evidence), and harms included increased risk for venous thromboembolism (fair evidence), stroke (fair evidence), dementia (fair evidence), and lower global cognitive function (fair evidence). There was fair evidence that unopposed estrogen had no beneficial effect on coronary heart disease. The USPSTF could not assess the effects of unopposed estrogen on the incidence of breast cancer, ovarian cancer, or colorectal cancer, as well as breast cancer mortality or all-cause mortality. A standard protocol was developed and followed for this review. Based on evidence from the previous review and using the methods of the USPSTF, USPSTF members and Agency for Healthcare Research and Quality (AHRQ) scientific staff determined the key questions for this update. Investigators created an analytic framework incorporating the key questions and outlining the patient populations, interventions, outcomes, and harms of menopausal hormone therapy. Key questions include: 1. What are the benefits of menopausal hormone therapy when used to prevent chronic conditions? 2. What are the harms of menopausal hormone therapy when used to prevent chronic conditions? 3. Do benefits and harms differ by subgroups? Subgroups include women with premature menopause; surgical menopause; age of use; types, doses, and modes of delivery of hormones; and presence of comorbidities.Description
Condition Guidelines
Books - New and Used
The following guidelines apply to books:
- New: A brand-new copy with cover and original protective wrapping intact. Books with markings of any kind on the cover or pages, books marked as "Bargain" or "Remainder," or with any other labels attached, may not be listed as New condition.
- Used - Good: All pages and cover are intact (including the dust cover, if applicable). Spine may show signs of wear. Pages may include limited notes and highlighting. May include "From the library of" labels. Shrink wrap, dust covers, or boxed set case may be missing. Item may be missing bundled media.
- Used - Acceptable: All pages and the cover are intact, but shrink wrap, dust covers, or boxed set case may be missing. Pages may include limited notes, highlighting, or minor water damage but the text is readable. Item may but the dust cover may be missing. Pages may include limited notes and highlighting, but the text cannot be obscured or unreadable.
Note: Some electronic material access codes are valid only for one user. For this reason, used books, including books listed in the Used – Like New condition, may not come with functional electronic material access codes.
Shipping & Delivery
Shipping Fees
- Stevens Books offers FREE SHIPPING everywhere in the United States for ALL non-book orders, and $3.99 for each book.
- Packages are shipped from Monday to Friday.
- No additional fees and charges.
Delivery Times
The usual time for processing an order is 24 hours (1 business day), but may vary depending on the availability of products ordered. This period excludes delivery times, which depend on your geographic location.
Estimated delivery times:
- Standard Shipping: 5-8 business days
- Expedited Shipping: 3-5 business days
Shipping method varies depending on what is being shipped.
Tracking
All orders are shipped with a tracking number. Once your order has left our warehouse, a confirmation e-mail with a tracking number will be sent to you. You will be able to track your package at all times.
Damaged Parcel
If your package has been delivered in a PO Box, please note that we are not responsible for any damage that may result (consequences of extreme temperatures, theft, etc.).
If you have any questions regarding shipping or want to know about the status of an order, please contact us or email to support@stevensbooks.com.
Returns & Refunds
You may return most items within 30 days of delivery for a full refund.
To be eligible for a return, your item must be unused and in the same condition that you received it. It must also be in the original packaging.
Several types of goods are exempt from being returned. Perishable goods such as food, flowers, newspapers or magazines cannot be returned. We also do not accept products that are intimate or sanitary goods, hazardous materials, or flammable liquids or gases.
Additional non-returnable items:
- Gift cards
- Downloadable software products
- Some health and personal care items
To complete your return, we require a tracking number, which shows the items which you already returned to us.
There are certain situations where only partial refunds are granted (if applicable)
- Book with obvious signs of use
- CD, DVD, VHS tape, software, video game, cassette tape, or vinyl record that has been opened
- Any item not in its original condition, is damaged or missing parts for reasons not due to our error
- Any item that is returned more than 30 days after delivery
Items returned to us as a result of our error will receive a full refund,some returns may be subject to a restocking fee of 7% of the total item price, please contact a customer care team member to see if your return is subject. Returns that arrived on time and were as described are subject to a restocking fee.
Items returned to us that were not the result of our error, including items returned to us due to an invalid or incomplete address, will be refunded the original item price less our standard restocking fees.
If the item is returned to us for any of the following reasons, a 15% restocking fee will be applied to your refund total and you will be asked to pay for return shipping:
- Item(s) no longer needed or wanted.
- Item(s) returned to us due to an invalid or incomplete address.
- Item(s) returned to us that were not a result of our error.
You should expect to receive your refund within four weeks of giving your package to the return shipper, however, in many cases you will receive a refund more quickly. This time period includes the transit time for us to receive your return from the shipper (5 to 10 business days), the time it takes us to process your return once we receive it (3 to 5 business days), and the time it takes your bank to process our refund request (5 to 10 business days).
If you need to return an item, please Contact Us with your order number and details about the product you would like to return. We will respond quickly with instructions for how to return items from your order.
Shipping Cost
We'll pay the return shipping costs if the return is a result of our error (you received an incorrect or defective item, etc.). In other cases, you will be responsible for paying for your own shipping costs for returning your item. Shipping costs are non-refundable. If you receive a refund, the cost of return shipping will be deducted from your refund.
Depending on where you live, the time it may take for your exchanged product to reach you, may vary.
If you are shipping an item over $75, you should consider using a trackable shipping service or purchasing shipping insurance. We don’t guarantee that we will receive your returned item.
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