Taking Hormones for Menopause Doesn’t Raise Early Death Risk

When examined by ten-year age groups, mortality outcomes were more favorable among younger women who received hormone therapy when compared to older women who also received the therapy.

Taking hormone pills for several years after menopause didn’t shorten older women’s lifespans, according to the longest follow-up yet of landmark research that transformed thinking on risks and benefits of a once popular treatment.

Researchers used data from the two trials which included postmenopausal women with an average age of 63 at enrollment – and explored the effect of treatment over a five to seven-year period, and 18 years of cumulative follow-up, and then defined the impact of hormone therapy on mortality rates by age group.

The WHI Estrogen-Plus-Progestin study was halted early, after 5.6 years, due to an increased risk of breast cancer, and the Estrogen-Alone study was stopped after 7.2 years because of increased stroke risk.

Cancer-related deaths linked to combination estrogen/progesterone therapy appeared to be a wash, as the treatment increased risk of breast cancer but decreased the risk of uterine cancer, Manson said. Additional research on the long-term benefits and risks of these newer treatments is needed, the researchers say. “It has been linked to certain benefits such as reducing hot flashes and menopausal symptoms, as well as reducing rates of bone fracture”. Brands studied were Prempro estrogen-progestin pills and Premarin estrogen-only pills.

The findings may help clinical decision-making, Manson said, because they support current recommendations that hormone therapy is appropriate for treating moderate to severe menopausal symptoms. “However, the findings do not provide support for the use of hormone therapy for the prevention of cardiovascular disease or other chronic diseases”, Manson said.

In an accompanying editorial, Melissa McNeil, MD, of the University of Pittsburgh, agreed with Manson.

“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.

“This study does not mean that a woman can nonchalantly start hormone therapy and stay on it for the rest of her life”, he said.

Manson’s group retrospectively pooled and analyzed data from the Estrogen-Plus-Progestin and the Estrogen-Alone clinical trials, conducted by the WHI.

Women who take hormone replacement therapy (HRT) to ease menopause symptoms like hot flashes and night sweats may be no more likely to die prematurely than women who don’t take hormones, a new study suggests. They were followed for 18 years and tracked for chronic diseases like cancer, as well as heart attack and deaths. Over the initial five to seven years when women were randomly assigned to take hormones or a placebo, death rates were about 30 percent lower among women aged 50 to 59 when they took HRT than when they didn’t. The landmark research, backed by the US government, began in the early 1990s to rigorously test hormones’ effects in older women randomly assigned to take the pills or dummy treatment.

An important limitation of the analysis was that the original trials used only one dose, formulation, and route of administration, so that the results may not apply to hormone therapies commonly used today, such as transdermal patches, the authors noted. Some co-authors disclosed multiple relevant relationships with industry including Amgen, Astra-Zeneca, Novo Nordisk, Novartis, Pfizer, and Genentech.

Manson disclosed no relevant relationships with industry.

McNeil disclosed no relevant relationships with industry.

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