There has been an on-going debate about the safety of menopausal hormone replacement therapy (MHT) in women who have reached their menopause. Women have been back and forth about continuing treatment in fear of causing serious harm to their health.
However there has been new evidence showing that this may not be the case.
An 18-year follow up study reported in the Journal of the American Medical Association confirmed that hormone replacement therapy does not actually increase the risk of premature death in those receiving treatment.
The concerns of premature death stem from a study in 2002 funded by the Women’s Health Initiative. This suggested synthetic hormonal drugs e.g. oestrogen and progesterone could lead to breast cancer, heart attack and even stroke.
Most women cease menstruating at the age of 48-55 years old due to the reduced production in oestrogen and progesterone. For women who require treatment for menopausal symptoms such as hot flashes, osteoporosis and vaginal atrophy, the benefits of taking HRT outweigh the risks.
However there have been a growing number of questions about the safety of HRT drugs and the implications on long term health in women.
Following the 2002 WHI study, the longer term new study examined 27,347 women aged 50-79 who took part in two clinical trials. The women had joined the study between 1993 and 1998 and were followed through till 2014. The first trial measured oestrogen vs a placebo and the second measured oestrogen combined with progesterone vs a placebo.
The women were on average 63 years of age and predominately healthy when they joined the randomised study, and the effect of their HRT treatment on mortality was measured over a 5-7 year period. They were then followed up for a total of 18 years, where the benefits and risks of MHT were assessed in terms of chronic disease prevention.
The use of the randomised trial ensured that participants were assigned to random groups, making the different groups highly comparable. The study did not however, take into account the varying dose in HRT or different formulations e.g. patches.
Not only was the death rate similar to those who did not take HRT (27%), the incidence of Alzheimer’s and dementia were lower in those taking medication containing oestrogen.
Although doubts may still remain about the safety of MHT, it is clear that there is growing evidence to suggest otherwise.
What do you think about the long term health effects of MHT? Let us know in the comment box below.
1) Manson J, Aragaki A, Rossouw J, et al. Menopausal hormone therapy and long term all-cause and cause-specific mortality: the Women’s Health Initiative randomized trials. JAMA 2017. doi: 10.1001/jama.2017.11217