Menopause Hormone Therapy Does Not Protect the Heart


A recent study looked at the use of hormone therapy during menopause and risk involved of developing coronary heart disease. This has been a topic of research for the last decade and medical professionals as well as women who are of menopausal age are very interested in this topic.

Previous studies have shown that estrogen plus progestin therapy in postmenopausal women increases the risk for coronary heart disease. However, this increased risk may be only limited to the first few years of hormone therapy and to women who begin hormone therapy after being menopausal for a while. The aim of the current study was to determine the effect of continuous use of estrogen plus progestin hormone therapy on coronary heart disease risk over a longer period of time.

In the recently reported study, data from 16,608 postmenopausal women who participated in the Women’s Health Initiative were analyzed. The Women’s Health Initiative is a very large study that was started in 1991 to learn about health issues in women who are postmenopausal. Over 15 years, more than 160,000 women aged 50-79 years participated in the study. Randomized controlled trials were included in this massive study and cardiovascular disease, cancer and osteoporosis were the main considerations in the study.

Over a decade ago, the Women’s Health Initiative showed that women who received hormone therapy had a higher likelihood of developing breast cancer, heart disease, blood clots and stroke compared to women who did not take hormone therapy. This finding led to much confusion about what to do regarding hormone therapy in menopausal women. It has since been recognized that those results were for women who started treatment years after the onset of menopause. The timing of using hormone therapy has remained a question.

The analysis in the recent study included a comparison between women who took estrogen plus progesterone as hormone therapy, women who took a placebo and women who used no hormone therapy or placebo. The risk for developing coronary heart disease was determined by measuring plaque progression in the arteries. The results from the study showed that the risk for developing cardiovascular problems was not decreased in the group of women that took estrogen plus progesterone as therapy during the first 2 years. This was also the case for women who began therapy within 10 years after the onset of menopause. A potential protective effect was observed in women who began hormone therapy closer to the onset of menopause after about 6 years of use.

The recent study was reported in the journal Annals of Internal Medicine and the researchers who carried out the analysis were from Brigham and Women’s Hospital in Boston.

Women often consider taking estrogen or estrogen and progesterone hormone therapy when entering menopause because of uncomfortable symptoms such as hot flashes, night sweats, mood swings or depression. The benefits of taking hormone therapy, however, must be weighed against the potential risk for developing health problems. Previous studies have suggested there may be some protective effect for the development of coronary heart disease from taking hormone therapy in early menopause at least for a short time, however, the current study has refuted this idea. A study coauthor is reported to have stated that the benefits of taking hormone therapy for symptom relief may outweigh the risks but hormone therapy is not recommended for the express purpose of trying to prevent heart disease in younger menopausal women.

By Margaret Lutze

Annals of Internal Medicine
Boston Globe

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