Why Hormone Replacement Therapy May Be Safer Than You Think

Why Hormone Replacement Therapy May Be Safer Than You Think

Why Hormone Replacement Therapy May Be Safer Than You Think

Hormone replacement therapy to treat symptoms of menopause does not increase a woman's risk of early death - either overall or specifically from cancer or heart disease, according to long-term findings from the largest clinical trial conducted on hormone therapy.

The landmark research, backed by the USA government, began in the early 1990s to rigorously test hormones' effects in older women randomly assigned to take the pills or dummy treatment.

"Women with existing health problems, for instance asthma, need to be followed more thoroughly through the menopausal transition and be provided with advice on medications that take the changing hormone levels better into account - ideally with a personalised approach", Triebner added.

The new study also showed that those who took combined hormone therapy of estrogen plus progestin had a 44 percent increase in breast cancer mortality, but that result failed to reach statistical significance.

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"This is good news for women", said JoAnn Manson, professor of medicine at Harvard Medical School and lead author of the study.

A long-term follow-up of more than 27,000 women who were part of the Women's Health Initiative found no link between hormone therapies used in the landmark study and deaths from cardiovascular disease, cancer or other major illnesses.

Overall, death rates were similar among women on both types of hormone treatment versus dummy pills.

But studies then found that the supplement hormones could lead to a higher risk of breast cancer-and that they didn't protect the heart after all.

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Both Dr. Shapiro and the Boston researchers note that the latest study examined the effects of hormone therapies used many years ago, at the start of the WHI study. The team also found that deaths from Alzheimer's Disease and other forms of dementia were significantly lower with estrogen-alone than with placebo during 18 years of follow-up, but use of estrogen plus progestin was not associated with dementia mortality. Hormone therapy is no longer widely recommended to prevent chronic disease like osteoporosis, heart disease or cancer, as they previously were.

"We observed a trend toward reduced mortality in younger women (age 50-59) who received hormone therapy, and neutral effects in older women (in their 60s and 70s) who received hormone therapy".

Over the extended follow-up period, overall mortality rates and deaths from cardiovascular disease and cancer were neither increased nor decreased among women who received hormone therapy. "In clinical decision making, these considerations must be weighed against the impact of untreated menopausal symptoms that women experience, including impaired quality of life, disrupted sleep, reduced work productivity and increased health care expenditures".

Today, there are new formulations of hormone therapies, which include lower doses and novel administration methods, such as skin patches, gels, and sprays.

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