It seems that every time one reads a recent article on estrogen replacement therapy, the risks and benefits have somewhat changed, recommendations have been altered, or new studies provide frankly surprisingly opposite conclusions compared with past ones.
Hormone therapy (HT) used to be routinely prescribed for postmenopausal women to relieve hot flashes and other menopause symptoms. Hormone replacement therapy was also thought to reduce the risk of heart disease. Does it?
Before menopause, women have a lower risk of heart disease than men do. But as women age, their risk of heart disease increases due to decreasing estrogen levels. About twenty years ago, we used to advise older women to take estrogen and other hormones to keep their hearts healthy. However, hormone therapy has had mixed results in this regard. Many of the hoped-for benefits failed to materialize for large numbers of women. The largest randomized, controlled trial to date actually found an insignificant increase in heart disease in postmenopausal women using hormone therapy.
Still, some data suggest that estrogen may decrease the risk of heart disease when taken early in postmenopausal years.
In a Danish study, after 10 years of treatment, women receiving HT early after menopause had a significantly reduced risk of mortality and heart disease symptoms, without any apparent increase in risk of cancer or stroke.
Another clinical trial, the Kronos Early Estrogen Prevention Study (KEEPS), exploring estrogen use and heart disease in younger postmenopausal women was recently completed, with results expected soon.
If you are having symptoms of menopause but are concerned about how hormone therapy will affect your heart, talk with your physician to put your personal risk into perspective.
The risk of heart disease to an individual woman taking hormone therapy is actually very low. If you are in early menopause and have hot flashes and other menopausal symptoms, and are otherwise healthy, the benefits of hormone therapy likely outweigh any potential risks of heart disease.
Your personal risk of heart disease depends on many factors, including your family history, personal medical history and your lifestyle.
If you're at low risk of heart disease, and your menopausal symptoms are significant, hormone therapy may be a reasonable consideration.
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Hormone replacement therapy and heart health: an update
Recommendation and review posted by Fredricko
