Deprescribing should be considered for older women already using which class of medications?

• A. Desiccated thyroid
• B. Growth hormone
• C. Androgens
• D. Estrogens with or without progestin

Answer: (D)

In older women, continuing therapy that contains estrogen—whether estrogen alone or with progestin—tends to do more harm than good. The risks of continuing such hormone therapy include cardiovascular events, blood clots, breast cancer, and potential cognitive or other adverse effects, and these risks often outweigh the benefits once a woman has reached older age. Because of that balance, deprescribing should be considered to reduce harm, especially if symptoms are manageable, there are new risk factors, or nonhormonal options can adequately address symptoms. If deprescribing is pursued, a careful plan to taper and monitor symptoms is helpful, with discussion of nonhormonal alternatives for relief if needed. The other listed medications—desiccated thyroid, growth hormone, and androgens—have their own safety concerns in older adults, but the strongest and most consistent deprescribing signal in this context targets estrogen-containing regimens.