New Study Confirms Hormone Therapy Benefits for Women Under 60

Recent research published in the journal JAMA highlights that hormone therapy (HT) is both safe and effective for easing menopause symptoms in women under 60. This new analysis draws from nearly two decades of data from the Women’s Health Initiative (WHI) study, which previously raised concerns about the safety of hormone therapy and led many women to discontinue its use.

Revisiting the WHI Study

The WHI study, conducted in the 1990s, involved over 160,000 postmenopausal women aged 50 to 79 to examine the effects of hormone therapy on menopause symptoms. The study was halted after finding that women taking Prempro, a combination of estrogen and progestin, faced increased risks of breast cancer, stroke, cardiovascular disease, and pulmonary embolism. This led to widespread skepticism about hormone therapy.

New Findings and Re-evaluation

The recent analysis challenges these earlier conclusions, particularly for women under 60. Dr. Garnet L. Anderson, co-author of the study and senior vice president at the Fred Hutchinson Cancer Center, emphasized that hormone therapy effectively reduces menopause symptoms with manageable risks for younger women. The study noted that while hormone therapy doesn’t significantly impact the risk of heart disease, stroke, or dementia in this age group, it isn’t particularly risky either.

Risks and Benefits

For women under 60, the additional risk of stroke from estrogen-progestin therapy is less than one extra case per 1,000 women, and there is no increased risk with estrogen alone. The therapy also significantly alleviates moderate-to-severe night sweats, hot flashes, and other menopausal symptoms. The risks of cardiovascular diseases and breast cancer are minimal in this age group, making the benefits of symptom relief outweigh the potential risks.

Broader Implications

The study also addressed non-hormone-related outcomes. It concluded that calcium and vitamin D supplements are not recommended for fracture prevention in postmenopausal women, though they can help fill dietary nutritional gaps. A low-fat diet rich in fruits, vegetables, and grains does not reduce the risk of breast or colorectal cancer but is associated with a lower risk of dying from breast cancer.

Limitations and Future Directions

Dr. Anderson acknowledged that the study had limitations, such as not testing all hormone therapy preparations and excluding women who experienced premature menopause due to surgery or chemotherapy. The primary aim was to assess long-term disease prevention rather than symptom relief.

Expert Opinions

Dr. Meleen Chuang from NYU Langone welcomed the updated findings, noting their significance for menopausal women under 60. She emphasized the need for continued research into the benefits and risks of hormone therapy, exploring alternative treatments, and understanding the long-term effects on diverse populations.

Dr. Lauren Streicher, however, criticized the study for downplaying hormone therapy’s potential in reducing aging-related health problems. She highlighted research showing that hormone therapy can decrease the risk of uterine cancer and improve mood, sleep, sexual function, joint pain, and cognitive function.

Considerations for Women

Women interested in hormone therapy should consult an OB/GYN specializing in menopause care. Not all doctors are up-to-date with current recommendations, so finding a knowledgeable specialist is crucial. Treatment should be personalized based on individual risk factors and symptoms, whether through hormone therapy or alternative options.

Conclusion

The new analysis underscores that hormone therapy is a safe and effective option for alleviating menopause symptoms in women under 60. While risks exist, they are minimal for this age group, making the benefits of symptom relief significant. Women should seek informed, personalized medical advice to navigate menopause treatment options effectively.