Hormone replacement therapy (HRT) for women can relieve the symptoms of menopause, whether it is hot flashes, vaginal dryness, or something else. HRT can also prevent osteoporosis. However, studies on HRT show contradicting results; some provide evidence for HRT lowering the risk of osteoporosis and heart disease, but other results associate it with increased risk of cancer and stroke.
A recent study from the Cedars-Sinai Medical Center dives into the controversy. "Over the past 15 years, fear of cancer and other risks has led to dramatically fewer women using hormone replacement therapy," explained senior author of the study, Daniel S. Berman, MD. Berman’s study will be presented at the American College of Cardiology's 66th Annual Scientific Session in a few days.
Despite these concerns, Berman’s study comparing women using HRT to relieve menopause symptoms to women not using HRT showed that women from the former group were at a lower risk of atherosclerosis and overall death.
To collect these results, Berman and his team conducted a health record analysis of over four thousand sets of results of coronary calcium CT scans conducted in women between 1998 and 2012. These scans measure the amount of calcium in the coronary arteries, which can alert doctors to the presence of plaque buildup that can lead to atherosclerosis, heart attack, and stroke.
Just under half of the women receiving coronary calcium CT scans were also undergoing HRT at the same time, and a large majority of these women were significantly older than the women not taking hormone replacement therapy, which required study researchers to make statistical adjustments before analyzing the final results.
With the age range of women in the study under consideration as well as other potentially confounding factors like diabetes status, blood pressure, and cholesterol levels, researchers were able to make several conclusions about the health effects of hormone replacement therapy.
First, women receiving hormone replacement therapy were 30 percent less likely to die than other women. They were also twenty percent more likely to have the lowest possible coronary calcium score which is associated with a low heart attack risk. Lastly, these women were also 36 percent less likely than other women to have a dangerously high coronary artery calcium score, increasing their risk of heart disease.
"This new study suggests that with proper screening and follow-up, therapy with supplemental estrogen or similar hormones may help improve heart health and overall survival in some women,” Berman said.
Berman and his team are already planning next-step studies to determine the relationship, if there is any, between women taking hormone replacement therapy and their risk of developing cancer.