Starting symptomatic women on hormone replacement therapy (HRT) as they transitioned through menopause used to be the standard of care. HRT helps with hot flashes, night sweats, mood swings, skin changes, concentration as well as a host of other symptoms. In 2002, results of the large, federally funded Women’s Health Initiative (WHI) study were published showing HRT was associated with an increased risk of breast cancer, heart attacks, and stroke. Since then many women have been reluctant to take any type of HRT.
JAMA recently published a study showing longer-term data from the WHI and found no increased risk of death when looking at all causes of mortality or when specifically looking at death from cancer or heart disease.
Following thousands of women: some on placebo, some on estrogen alone and some on estrogen and progesterone, found similar rates of death over the study period. Women who started HRT between the ages of 50-59 had a 30% lower risk of death compared to women who did not receive HRT.
So much has evolved in HRT since the WHI study was conducted. Most HRT is given transdermally or transvaginally, which allows for much lower doses to be given. Even lower doses that traditionally prescribed are now also available as well as a third hormone: DHEA. Methods of detecting breast cancer and treatments for breast cancer have also decreased mortality from the diagnosis.
What this does mean, for the right woman at the right time, HRT is safe, effective and is unlikely to increase her risk of earlier mortality.
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