Hormone Therapy for Women: Timing Matters

Hormone therapy initiated soon after menopause onset may decrease heart disease risk

/ Author:  / Reviewed by: Beth Bolt, RPh

(RxWiki News) Hormone therapy for menopause has been a controversial subject for some time, primarily because of its link to heart disease risk.

But a new study from Sweden found that the issue may actually be related to the timing of treatment, rather than the treatment itself. Women who began hormone therapy (HT) soon after menopause onset had a lower risk of future heart disease than women who began later.

"We realized that, for all of the studies completed, few had taken into consideration the timing of HT initiation in relation to the onset of menopause," said lead study author G.D. Carrasquilla, in a press release. "What we found is that there is a difference with regard to the onset of coronary heart disease depending on when a woman started taking hormones and when she started menopause."

Carrasquilla is a PhD candidate in cardiovascular epidemiology at the Karolinska Institutet in Stockholm.

According to the National Heart, Lung, and Blood Institute, past research has found that women who use certain kinds of hormone therapy may have an increased risk of heart disease, breast cancer, blood clots and stroke.

After women enter menopause, their hormone levels begin to fall, which can lead to problems like osteoporosis, hot flashes and vaginal dryness. Hormone therapy addresses these falling hormone levels with the female hormones estrogen and progesterone.

For this study, Carrasquilla and team looked at data from five Swedish studies on more than 74,000 women. These women were followed for up to 22 years, with the average follow-up period being 13 years.

Other factors that might affect heart disease risk, such as smoking, age at menopause onset and chronic conditions like diabetes, high blood pressure and high cholesterol, were accounted for.

Carrasquilla and team divided the women into three groups.

The first group had never used hormone therapy, the second group used hormone therapy within five years of menopause onset and the third group did not begin hormone therapy until five years after menopause onset.

The women who began hormone therapy within five years of onset had a lower risk of heart disease than the other two groups.

By comparison, the women who began hormone therapy five or more years after onset had an increased risk of heart disease.

This study was presented Sept. 30 at the 2015 Annual Meeting of the North American Menopause Society. Research presented at conferences may not have been peer-reviewed.

Information on funding and conflicts of interest was not available at the time of publication.

Reviewed by: 
Review Date: 
September 29, 2015
Last Updated:
October 5, 2015