Health Care

Menopause hormones don't shorten lives, long follow-up says

Menopause hormones don't shorten lives, long follow-up says”

The Women's Health Initiative (WHI) study looked at the effects of estrogen-only and estrogen-progestin combination therapies used in menopausal women to prevent age-related diseases.

She said the findings suggest it's safe for women between the ages of 50 and 60 to try hormone therapy for treatment of menopause symptoms, but not for chronic disease prevention.

A long-term follow-up of more than 27,000 women who were part of the Women's Health Initiative found no link between hormone therapies used in the landmark study and deaths from cardiovascular disease, cancer or other major illnesses.

The percentage of deaths from any cause in women from the hormone therapy group was 27.1 per cent, nearly identical to the 27.6 per cent in the placebo group, suggesting HRT had no effect on mortality rates. The study was halted in 2002, after investigators found the hormone therapy appeared to put women at greater risk of invasive breast cancer, strokes and heart disease.

"It's the ultimate bottom line", said Manson, who was also part of the original research. 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.

Participants were aged 50 to 79 and past menopause, older than typical users, and took larger doses than now recommended.

While the study found no overall increase or decrease in death rates among women between the ages of 50 and 79, the mortality rates were lowest among younger women in the group (aged 50 to 59).

But an 18-year follow-up on these women has shown that there wasn't an increase to risks of death and other disease on those who used the hormones.

Overall, nearly 7,500 women died - about 27 percent each in the hormone and dummy pill groups.

But women who took HRT - where these hormones are prescribed - for two or more years lost an average of 46 ml less of lung volume compared with women who never took HRT. However, among women who initiated hormone therapy in their 60s and 70s, no effect on death rate was observed.

Overall, death rates were similar among women on both types of hormone treatment versus dummy pills.

The pendulum has swung from one extreme to the other when it comes to hormone replacement therapy (HRT) to treat symptoms of menopause.

"Women with existing health problems, for instance asthma, need to be followed more thoroughly through the menopausal transition and be provided with advice on medications that take the changing hormone levels better into account - ideally with a personalised approach", Triebner added. An editorial published with the follow-up study says the results "will hopefully alleviate concerns" about the long-term consequences. "But that is the reason that all-cause mortality is such an important summary measure, since interventions like hormone therapy can have a complex pattern of benefits and risks".



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