A new Danish study offers some reassurance to women using hormone replacement therapy (HRT) for menopausal symptoms: the treatment may not only ease discomfort from hot flashes, but early use also appears not to increase the women’s risk of heart problems or death.
Skepticism surrounding hormone replacement therapy stems from the results of the landmark Women’s Health Initiative (WHI), a large federal study that was halted in 2002 when study authors linked estrogen-progestin pills to increased risks for heart disease and breast cancer.
Since then, follow-up studies have begun to clarify some of the risks and benefits, finding that, for example, women who take estrogen-only hormone therapy (instead of combination estrogen-progestin pills) shortly after menopause don’t have the same elevated heart risks.
In fact, they may even enjoy a lower risk of breast cancer. Only women who have had hysterectomies can take estrogen-only hormone treatments.
In the new study, published in the journal BMJ, researchers divided 1,006 recently menopausal women aged 45 to 58 into one of two groups: an HRT group and a non-HRT group (the women not taking HRT also did not receive a placebo).
Originally, the study, whose participants were initially enrolled in 1990-93, was intended to last 20 years. But at ten years, when results from the WHI came out, the researchers recommended that participants stop taking their hormones. At this point, more women in the non-HRT group had died from heart-related causes.
The researchers continued to track the women for an additional six years and found that women in the HRT group were still less likely to die from heart-related incidents.
By the end of the study, 23 women in the non-HRT group had died of cardiovascular-related causes, and 17 had died of unrelated causes, compared with six women who had died of heart disease among the HRT group and 21 who died from other causes.
Women taking HRT were also less likely to experience a heart attack or heart failure. The authors further report no apparent increase of cancer or stroke among women getting hormone therapy.
Health experts are not quick to change current recommendations for HRT use: doctors prescribe hormone therapy only to relieve the worst menopause symptoms and only for short periods of time, not to prevent chronic conditions like heart disease, cancer or dementia.
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