Feb. 16, 2010 -- Women who take combined hormone therapy for just a few
years around the time of menopause appear to have no decrease in heart disease
risk, new research suggests. If anything, their risk may go up slightly.
The analysis of data from the study that first linked hormone therapy to
heart disease found that even in the first two years of use, treatment with
estrogen plus progestin was associated with a small, but not statistically
significant increase in heart risk when started within 10 years of
The number of menopausal women in the study who had heart attacks and
strokes was quite small, however, and experts say the advice to those
contemplating hormone therapy for the relief of hot flashes and other
menopausal symptoms remains unchanged.
“Our findings are consistent with the current guidelines to use hormone
therapy in the smallest doses for the shortest possible time for symptoms
only,” lead researcher Sengwee Toh, ScD, of Harvard Medical School tells WebMD.
“We found no evidence of a protective benefit in the early years of use.”
It is now well known that taking combined hormone therapy for many years is
associated with an increased risk for heart attacks and strokes in older women
who are well past menopause.
But it has not been clear if this risk extends to women who take hormones
for just a few years around the time of menopause.
Some studies even suggest that short-term hormone therapy may actually be
protective against heart disease in younger women.
In an effort to better understand the impact of combined hormone treatment
on heart disease risk around the time of menopause, Toh and colleagues examined
data from the widely publicized hormone therapy intervention trial known as the
Women’s Health Initiative (WHI).
The WHI included more than 16,000 women, half of whom were randomized to
receive combined estrogen plus progestin hormone therapy between 1993 and 1998.
The other half of the group received placebos. In 2002, the hormone therapy arm
of the trial was suspended because of increased rates of heart disease, breast
cancer, and blood clots. Toh and colleagues looked more closely at the data to
see if outcomes were influenced by the time span between menopause onset and
start of hormone therapy.
Compared to women randomized to the placebo arm of the trial, women who
commenced combined hormone therapy within 10 years of menopause had a slight
increase in heart disease risk during the first two years of use, but this
increase in risk did not reach statistical significance and was considered
Perhaps the more important finding was that there was clearly no evidence of
a protective effect.
“The available evidence suggests that estrogen plus progestin therapy does
not reduce the risk for coronary heart disease during the first 3 to 6 years of
use in women who initiated therapy close to menopause,” Toh and colleagues
write. “Because the typical duration of use of hormone therapy is short, most
women contemplating estrogen plus progestin therapy for the relief of
menopausal symptoms should not expect protection against heart disease.”