Hormone replacement therapy safer for some women than originally thought

For many years, hormone replacement therapy as a solution to the symptoms of menopause was considered to present more benefits than risks. However, this belief changed with the release of large-scale studies showing that the treatment appeared to increase the risk of heart attack and breast cancer. An analysis of data from a sub-group of participants in a large-scale epidemiological study found that hormone therapy may be safer in women who have had a hysterectomy

Most women are prescribed both estrogen and progesterone to treat the symptoms of menopause; this is called hormone replacement therapy. Estrogen is used to treat hot flashes, while progesterone is added for women who still have their uterus in order to prevent hyperplasia (thickening) of its lining.

For many years, hormone replacement therapy as a solution to the symptoms of menopause was considered to present more benefits than risks. However, this belief changed with the release of large-scale studies showing that the treatment appeared to increase the risk of heart attack and breast cancer.

An analysis of data from a sub-group of participants in a large-scale epidemiological study found that hormone therapy may be safer in women who have had a hysterectomy. Since these women no longer have a uterus, they do not need to take progesterone. For this study, over 10,000 women were given estrogen or a placebo for approximately six years and were then followed for nearly eleven years after the end of the treatment.

Among this sub-group, taking estrogen to relieve the effects of menopause was associated with a 23 percent lower risk of breast cancer. When compared with the placebo group, taking estrogen alone was not associated with any difference in the risk of blood clots, stroke, hip fracture or colon cancer, or in overall death rates. Another surprising difference was in the heart attack risk according to age groups. Women in their fifties had a significantly lower risk of cardiovascular diseases, including almost 50 percent fewer heart attacks. Conversely, women in their seventies using estrogen had a clearly higher risk of cardiovascular diseases. The risk therefore varies with age, and this should be taken into account when deciding whether to continue the hormone therapy.

These results are reassuring for women over the age of fifty who have had a hysterectomy and are using hormone therapy. However, the study findings in no way change the recommendations for women who still have their uterus. In these women, it is recommended that hormone replacement therapy only be used in cases where menopause symptoms are severe, and that the lowest possible dose be used for the shortest possible period of time.

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