The Year in Review for Hormone Therapy Studies, A Summary
The peer reviewed Journal, Menopause, had several stories in 2011 that showed improved outcomes for women who received hormone replacement therapy. The journal even had a study that showed that women who discontinued hormone replacement therapy (HRT) were worse off than women who continued hormone therapy.
The first study, published in March 2011, looked at the effects of hormone therapy on dying from heart disease or risk of developing heart disease while on hormone replacement therapy. This study used data from the California Teacher’s Stucy (CTS) which is a group of retired female teachers. Over 71,000 women completed a baseline questionnaire in 1995 and then were followed until 2004. This study’s findings were in opposition with some of the now popularized data from the results seen in the Women’s Health Initiative (WHI) study.
The WHI study was stopped prematurely in 2002 because of an increased risk of heart disease and breast cancer. In this current study the researchers actually found a decreased risk of heart disease in women who had taken HRT. This risk was seen to be best in younger women (36-59) and tapered off as women aged, but even in the oldest age group (70-84) there was no increased risk of heart disease at all with hormone replacement therapy. It is interesting to note that these women were on varying kinds of HRT including estrogen only or estrogen/progestin.
The arm of the WHI that showed that women had an increased risk of heart disease was women who took the combination of estrogen with progestin known as Prempro. Additionally, this reduction in cardiovascular risk was seen in the WHI in the youngest women in the study. Women who started HRT in the WHI in the age group also had a reduction in cardiovascular disease and risk did not increase until women waited until after age 59 to start HRT. This study again confirms that especially for women under age 59, there is a cardiovascular benefit to HRT and that there is no increased risk of cardiovascular disease with HRT, even in older women.
The other study that was published in November of 2011 looked bone health in women who had stopped HRT. After the WHI study was stopped in 2002, women were taken off of HRT in huge numbers. This study looked at the impact of discontinuation of HRT on the women’s bones, specifically their risk of hip fracture. A group of over 80,000 women from Kaiser Permanente HMO were studied. The researchers analyzed data on women who had stopped HRT and women who continued HRT. They had bone density results on over 50,000 women that they analyzed. After 6.5 years of follow up of the two groups, the researchers showed that women who stopped HRT therapy had a 55% greater risk of hip fracture compared with those who continued using HRT. The hip fracture risk increased as early as 2 years after stopping hormone replacement therapy. This risk increased more the longer a woman was followed after she had stopped HRT. The longer it had been since a woman had stopped her HRT correlated with having a lower bone density score.
These results have an enormous impact on the risk of women for having a hip fracture.
These two studies taken together reassure us that HRT will not increase our risk of heart disease and will likely lower it, especially if HRT is started before age 59. Additionally, stopping HRT has been shown to be linked with lower bone density and a much higher risk of hip fracture. Women need to know that they have choices when it comes to hormone replacement therapy. It is important for women to know this information so they can make an informed decision regarding hormone therapy when they reach menopause.
Reference: Menopause Journal
Bioidentical Hormone Replacement Therapy trailerblazer Dr. Jennifer Landa, MD, Chief Medical Officer of BodyLogicMD, and author of the forthcoming Sex Drive Solution for Women: Dr. Jen’s Power Plan to Fire Up Your Libido (Atlantic Publishing Group; February, 2012).