Hormone Therapy for Menopause and Heart Disease

When it comes to drugs and other medical treatments, what a difference a decade makes. For instance, take hormone therapy– or rather don’t! – at least not until you have all the latest facts based on current research evidence.

Hormone therapy for menopausal women involves taking prescribed doses of estrogen or a combination of estrogen and progesterone to help replace levels which typically lower during menopause. This helps ease symptoms associated with menopause, such as itchy and/or dry skin and the dreaded hot flashes and night sweats. Remember the TV ad with the 50+ woman trudging out to the backyard in the midst of a snowstorm to uncover the air conditioner? Not so funny to those who can relate to her anguish!  

Hormone therapy was also believed to help protect against some serious age-related conditions including heart disease. Since women’s risk for heart attack and stroke increases after menopause and during senior years, it seems like good timing to use hormones to ward off both menopause symptoms and heart problems. Can’t hurt, right?

Well as it turns out, it can. In the past 10-15 years, a few large-scale studies have focused on the impact of hormone therapy, including one as part of the Women’s Health Initiative, a long-term U.S. based health study. The results of that trial challenged long-held assumptions, showing that not only was there no evidence of any protective benefits of hormone therapy for heart health, it can actually increase the risk of heart disease for some women.

Since then, many more studies have been conducted in an effort to either confirm or refute those game-changing findings.

What the research tells us:

• Hormone therapy did not lower the risk of death from heart disease for postmenopausal women.
• There was evidence that hormone therapy increased the risk of stroke, clots in the arms or legs (venous thromboembolism) and clots in the lungs (pulmonary embolism) by a small degree.

Does this mean all women should avoid hormone therapy? Not necessarily. For some, the benefits (relief from menopause symptoms) may outweigh the risks, especially as risk varies depending on age, general health, the amount of time since menopause, and other health/lifestyle factors. In fact, younger women and those who had more recently gone through menopause showed a slightly lower risk of dying and of heart disease when they used hormone therapy. They still faced increased risk of clots and stroke, however. 

For the time being, it is not recommended that anyone take hormone therapy solely to prevent heart disease.

Studies like these underline the importance of working with your doctor and having up-to-date, complete and accurate information – including any side effects or potential harms – before starting any new medication, therapy or procedure.