Hormone Replacement Therapy Does Not Increase Early Death In Women

Henrietta Strickland
September 13, 2017

The landmark research, backed by the US government, began in the early 1990s to rigorously test hormones' effects in older women randomly assigned to take the pills or dummy treatment.

The 18-year follow-up research of 27,000 women who were part of the original study, found that they were no more likely to die of any cause than women who took placebo pills.

According to the study, menopause, where the level of female hormones such as estrogen and progesterone fall, accelerates the decline in lung function.

Over this extended follow-up period, overall mortality rates and deaths from cardiovascular disease and cancer were neither increased nor decreased among women who received hormone therapy.

That research was halted early when more breast cancer, heart attacks and strokes occurred in women on combined pills than in dummy pill users.

"These findings provide support for clinical guidelines endorsing the use of hormone therapy for recently menopausal women to manage bothersome hot flashes and other menopausal symptoms", Manson said.

The WHI trial tracked more than 27,000 women, average age 63, who received either hormone replacement therapy or a placebo between 1993 and 1998.

"When you're testing a medication that has a complex pattern of benefits and risks, all-cause or total mortality is the ultimate bottom line when assessing the net effect of a medication on serious or life-threatening outcomes", Manson said. Most professional health groups, including the North American Menopause Society and the U.S. Preventive Services Task Force, now advise using the supplemental hormones for the shortest period possible, in the lowest dose needed, just to relieve the most severe symptoms of menopause.

Past studies looked at specific health effects of hormone replacement therapy and deaths from specific causes, such as cancer and heart disease.

Overall, nearly 7,500 women died - 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.

Among the youngest women, there were fewer overall deaths early on among hormone users than dummy-pill users, but the rates evened out after women stopped using the pills.

Both Dr. Shapiro and the Boston researchers note that the latest study examined the effects of hormone therapies used many years ago, at the start of the WHI study.

Death rates were similar among women on both types of hormone treatment versus dummy pills.

While HRT can help with menopausal symptoms and protects against osteoporosis, it has also been linked with an increase in the risk of breast cancer and heart and blood vessel problems.

Even so, many women and their doctors remain wary of hormone use.

"We need more research on the benefits and risks of some of these newer formulations", Manson said.

Other reports by Click Lancashire

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