12 September, 2017
Boston, MA- The Women's Health Initiative (WHI) hormone therapy trials tested the most common formulations of hormone therapy - estrogen and progestin, and estrogen alone - to assess the benefits and risks of menopausal hormone therapy taken for chronic disease prevention, by predominantly healthy postmenopausal women.
She said the findings suggest it's safe for women between the ages of 50 and 60 to try hormone therapy for treatment of menopause symptoms, but not for chronic disease prevention.
"It is a bit surprising that given the many risks of hormone therapy identified during the treatment phase, the net effect on all-cause mortality was neutral", says Manson, who leads one of the WHI's multiple study sites. But studies then found that the supplement hormones could lead to a higher risk of breast cancer-and that they didn't protect the heart after all.
Hormone replacement therapy (HRT), used to treat common symptoms of menopause, can help slow the decline in lung function in middle-aged women, according to new research.
By the end of the 18-year study, the death rates from any cause among the women receiving some form of hormone therapy were similar to that of women who took the placebo.
That research was halted early when more breast cancer, heart attacks and strokes occurred in women on combined pills than in dummy pill users. "Women want to know 'is this medication going to kill me" and the answer appears to be no.
For the study, presented at the European Respiratory Society International Congress in Milan, Italy, the team followed 3,713 women for approximately 20 years from the early 1990s to 2010.
Participants were aged 50 to 79 and past menopause, older than typical users, and took larger doses than now recommended.
But an 18-year follow-up on these women has shown that there wasn't an increase to risks of death and other disease on those who used the hormones.
The follow-up involved most of the more than 27,000 women who were part of the original research. After 18 years, which included 10-12 years of follow-up after stopping hormone therapy, the differences by age group diminished and were no longer statistically significant.
Overall, nearly 7,500 women died, which was about 27 percent each in the hormone and dummy pill groups. About 9 percent of women in both groups died from heart disease and about 8 percent from breast and other cancers.
Death rates were similar among women on both types of hormone treatment versus dummy pills. Even so, many women and their doctors remain wary of hormone use. "In clinical decision making, these considerations must be weighed against the impact of untreated menopausal symptoms that women experience, including impaired quality of life, disrupted sleep, reduced work productivity and increased health care expenditures". An editorial published with the follow-up study says the results "will hopefully alleviate concerns" about the long-term consequences.
More research is needed on risks and benefits of other types of hormones including patches, Mason said.