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Hormone Therapy Does Not Increase Risk of Death in Postmenopausal Women

CardioSmart News

Despite concerns about its negative health effects, short-term use of hormone therapy does not increase mortality risk in postmenopausal women, based on extended follow-up from the Women’s Health Initiative trials.

Published in the Journal of the American Medical Association, this study looked at the impact of short-term use of hormone therapy on future mortality risk in women. Hormone therapy is often used to treat symptoms of menopause, although the risks and benefits are both complex and uncertain.

The recent study included extended follow-up data from the Women’s Health Initiative hormone therapy trials, which assessed the risks and benefits of menopausal hormone therapy in healthy women. The first trial, which tested the use of estrogen alone, was stopped after 5 years due to an increased risk of breast cancer, while the second that tested estrogen plus progesterone was stopped after 7 years due to increased risk of stroke.

Given the significant concerns raised by trial findings, the risks and benefits of hormone therapy remain highly controversial. Since the issue is so complex, researchers recently looked at risk of death as a simpler way to assess outcomes.

In the recent study, researchers conducted an 18–year analysis of more than 27,000 participants from the Women’s Health Initiative trial. Women were 63 on average at the start of the study and took either estrogen, estrogen plus progesterone or a placebo pill with no active ingredients before the trials were cut short.

Using national death records, researchers found that roughly 7,500 participants had died during the 18–year follow up period. The good news, however, is that hormone use appeared to have no impact on risk of death. Analysis showed that there were no significant differences in all-cause mortality rates among women taking estrogen, estrogen plus progesterone or the inactive placebo. Researchers also note that the proportion of cancer and heart-related deaths were the same among the hormone and placebo groups.

What findings show, according to authors, is that hormone therapy appears to be safe for short term use for women with troubling vasomotor symptoms, premature menopause, or early-onset osteoporosis. However, it’s important to note that findings only apply to women who took estrogen or estrogen plus progesterone for 5–7 years, which is relatively short-term.

Experts hope this information will be helpful in counseling women considering whether to start hormone therapy and hopefully will alleviate concerns that many patients and physicians have had about the initiation of hormone therapy.

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