Hormone Therapy Being Reconsidered for Her Health

Estrogen therapy has been the subject of debate for more than three decades. There was a day when doctors would recommend nearly all menopausal women take hormones to alleviate the symptoms of that stage of life. That changed in the early part of the 21st century when new data seem to indicate that hormone therapy did not benefit women as advertised. Furthermore, there was newfound concern that taking estrogen and progestin increased the risk of breast cancer, heart disease, and stroke.

To say that women have been confused about hormone therapy is to state the obvious. Even today, there is no shortage of doctors on both sides of the issue that cannot seem to agree on whether hormone therapy is appropriate for menopausal women or not. And now there is even more fuel for the fire: data from two separate studies that indicate supplemental estrogen, if taken early enough, may reduce the risk of coronary heart disease in postmenopausal women.

For the record, this new data by no means closes the case on estrogen and progestin therapy. But the substantial evidence provided by the two studies seems to suggest that the whole idea behind hormone therapy was right in theory, just not implemented correctly in the past. The key appears to be the age at which a woman begins taking supplemental hormones.

The Sooner the Better

A study recently published in the New England Journal of Medicine looked at more than 600 postmenopausal women who showed no evidence of heart disease. The focus of this study was to determine how hormone therapy relates to the risk of developing heart disease based on the age at which a woman begins taking supplemental estrogen. The group was divided into those starting therapy within six years of menopause and those waiting until ten years or later.

To summarize, the data demonstrated that those women who took supplemental hormones within six years of menopause showed less thickening of the arteries than those who either took the placebo within six years or who waited until ten years to begin therapy.

More exciting is the fact that the results of the study coincide with a Danish study in 2012 involving 1,000 women. That study showed that those who took supplemental hormones for ten years were less likely to suffer from heart attack or heart failure, as long as therapy was started within one year of menopause. The same women showed no increased risk for cancer, stroke, or blood clots.

A New Line of Thinking

Because thickening blood vessels are believed to be a contributor to heart disease, medical science is now reconsidering hormone therapy as a means of preventing coronary heart disease in postmenopausal women. The idea is that starting the therapy early enough can reduce the amount of thickening that takes place, whereas waiting too long may result in an amount of thickening that cannot be overcome.

No one is ready to yet say that hormone therapy is the way to go for all women entering menopause.
But it is at least worth considering further investigation. It could be that our misunderstanding of the endocrine system may have previously caused us to use a very good therapy in the wrong way. If further studies indicate that replacement hormones can indeed reduce the risk of heart disease without increasing other risks, we could be on the way to finding a new way to use supplemental hormones to help women.