Menopause Hormone Treatment, Heart Risk


The use of hormone replacement therapy, or HRT, in postmenopausal women may increase women’s heart disease risk, according to a study published in the Journal of the American Medical Association Internal Medicine.

The findings are a follow-up to a landmark study that started in 1991 and examined 162,000 postmenopausal women separated into groups taking a placebo, estrogen or an estrogen and progestin combination. The original study examined the long held belief that HRT was effective not only in treating menopausal symptoms but also conditions such as heart disease.

Each woman was tracked for five to seven years and when the findings of the study were release in 2002, it was discovered that women taking estrogen and progestin had higher risks of heart disease and breast cancer than those taking the placebo. This finding resulted in millions of women stopping HRT and, according to CBS News, today only 10 percent of women take HRT.

Women Taking HRT Show Increased Heart Disease, Breast Cancer Risk

The follow-up study shows that long-term HRT can increase a postmenopausal woman’s risk of heart disease and breast cancer. The new research shows that a combination of therapies significantly increased risk of breast cancer, accounting for nine cases in every 10,000 women, as well as more strokes and blood clots. The use of a combination of estrogen and progestin carried more risks than taking estrogen alone.

“This study underscores that estrogen is not useful in the prevention of cardiovascular disease,” says Dr. Gina Lundberg, a preventive cardiologist with Emory Healthcare and a national spokesperson for the American Heart Association.

The study also showed that negative effects of HRT were felt most strongly in older women.

“In general, I advise women to avoid hormone replacement when possible and only take the lowest dose necessary when needed for symptomatic menopausal relief. And I encourage all women to start weaning off estrogen starting at age 59 and be completely off by age 65,” she says.

Even with this research, there may still be some healthy effects of HRT for women with severe menopausal symptoms.

Lundberg says, “Women should avoid hormone replacement for prevention of heart disease. However, when estrogen is needed for significant menopausal symptoms, the lowest dose for the shortest amount of time is generally safe.”

Learn more about heart disease and menopause on Go Red.