Population	Postmenopausal women	Postmenopausal women who have had a hysterectomy
Recommendation	Do not prescribe combined estrogen and progestin for the prevention of chronic conditions.	Do not prescribe estrogen for the prevention of chronic conditions.
	Grade: D	Grade: D
Risk assessment	This recommendation applies to the average-risk population. Risk factors for a specific chronic disease or individual characteristics that affect the likelihood of a specific therapy-associated adverse event may cause a woman's net balance of benefits and harms to differ from that of the average population.
Preventive medications	Although combined estrogen and progestin therapy (specifically, oral conjugated equine estrogen, 0.625 mg per day, plus medroxyprogesterone acetate, 2.5 mg per day) decreases the risk of fractures in postmenopausal women, there is an accompanying increased risk of serious adverse events, such as stroke, invasive breast cancer, dementia, gallbladder disease, deep venous thrombosis, and pulmonary embolism.
	Estrogen therapy (specifically, oral conjugated equine estrogen, 0.625 mg per day) decreases the risk of fractures and has a small effect on the risk of invasive breast cancer, but it is also associated with important harms, such as an increased likelihood of stroke, deep venous thrombosis, and gallbladder disease.
	Neither combined estrogen and progestin therapy nor estrogen alone reduces the risk of coronary heart disease in postmenopausal women.
Balance of harms and benefits	The chronic disease prevention benefits of combined estrogen and progestin do not outweigh the harms in most postmenopausal women.	The chronic disease prevention benefits of estrogen are unlikely to outweigh the harms in most postmenopausal women who have had a hysterectomy.
Other relevant USPSTF recommendations	The USPSTF has made recommendations on screening for osteoporosis and the use of preventive medications for breast cancer, as well as other relevant interventions for the primary or secondary prevention of chronic diseases in women, such as medications for cardiovascular disease and screening for coronary heart disease, high blood pressure, lipid disorders, colorectal cancer, breast cancer, and dementia. These recommendations are available at http://www.uspreventiveservicestaskforce.org/.