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Hormone Therapy May Benefit Some Women's Hearts

By
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 9, 2012 -- Hormone replacement therapy (HRT) may do more than ease hot flashes and mood swings. A new study suggests that women who start taking hormones during menopause might get some protection against heart disease without seeing increases in other serious risks.

The study, which was published in BMJ, tested a theory called the timing hypothesis.

In older women many years past menopause, hormone replacement therapy using both estrogen and progesterone has been shown to raise risks for heart attacks, strokes, blood clots, dementia, and breast cancer.

What’s been less clear is whether hormones might be safer and more beneficial if they are replaced as they naturally start to drop off, around the time of menopause.

Though the results of the new study look promising, experts who were not involved in the research caution that it is not a game-changer.

“This trial is not a trial that’s going to change how we prescribe hormone replacement therapy. This isn’t going to change practice. There are issues about this trial,” says Suzanne Steinbaum, MD, director of Women and Heart Disease at Lenox Hill Hospital in New York City.

But she says the new results are intriguing and should open the door to more research.

“Women who are symptomatic with hot flashes, difficulty sleeping, mood swings, difficulty concentrating, who are recently menopausal, these women actually might benefit from HRT. Not just for symptom relief, but for preventing heart attacks and deaths,” Steinbaum says.

Hormone Replacement for Younger Women

The study randomly split 1,006 healthy women in Denmark into two groups: The first group got HRT; the second group got no treatment. All the women in the study were near menopause and no more than two years away from their last menstrual period.

The study was designed to run for 20 years. But researchers stopped it early -- after 10 years -- when results from the large Women’s Health Initiative (WHI) study a decade ago found that women taking combined hormone therapy had more heart attacks, strokes, dangerous blood clots in the legs and lungs, and breast cancer than women taking placebo pills.

Fearing for the safety of the women in their study, the Danish researchers advised them to stop taking their hormones. But they continued to chart the women’s health for nearly six more years.

In contrast to what happened in the WHI, the Danish women who took HRT were less likely to die over the course of the study or be hospitalized because of a heart attack or heart failure.  

There were no meaningful differences in strokes, dangerous blood clots, or cancers between the two groups.

“I think this is a breakthrough in the sense that this is what most doctors in the field have believed is the truth,” says researcher Louise Schierbeck, MD, an endocrinologist at Hvidovre Hospital in Denmark.

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