Evaluating benefits and harms of systemic MHT
Before starting systemic MHT, exclude contraindications and consider the expected benefits versus possible harms. See Benefits and harms of combined MHT and Benefits and harms of estrogen-only MHT.
The balance of benefits and harms is likely to be favourable in people younger than 60 years.
The sections below summarise data from the US Preventive Services Task Force meta-analysis of randomised controlled trials in postmenopausal individuals (in which mean ages of participants in the different trials ranged from 53 to 79 years), and indicate the likely magnitude of benefits and harms1. Most of these data come from the Women’s Health Initiative trials, which only examined oral MHT (conjugated estrogens plus medroxyprogesterone).
Other forms of systemic MHT (tibolone and conjugated estrogens+bazedoxifene) are considered separately.