Hormone Therapy Found Safe for the Hearts of Women Below Age 60 Experiencing Symptoms of Menopause

But starting after age 70 should be avoided due to high cardiovascular risk

Using data from the Women’s Health Initiative trials, researchers have confirmed that hormone therapy (HT) is heart safe and appropriate for treating women aged 50-59 who are experiencing bothersome menopause symptoms, including hot flashes and night sweats, but not for women initiating treatment after age 70.

Many patients and clinicians have been hesitant to use HT to treat menopause due to concerns about increased risk of cardiovascular disease. In a new study, researchers looked at 20 years of data from more than 27,000 women ages 50 to 79 with moderate to severe menopausal symptoms who were randomized to receive HT or placebo. Compared to placebo, women who started HT between the ages of 50 and 59 did not have increased risk of cardiovascular outcomes. But in women older than 70 on HT, there was a substantially increased risk of atherosclerotic cardiovascular disease. This is the first study to look closely at the relationship between hot flashes, HT, and cardiovascular disease and how it varies by age group.

“This paper has a very important message for clinicians and women considering HT use: HT is appropriate and has a favorable benefit: risk profile for treating hot flashes among women below age 60, but it’s important to avoid starting treatment after age 70 among women with hot flashes. Our findings support current HT guidelines but help to clarify that risk varies strongly by age,” said co-author JoAnn Manson, MD, DrPH, chief of the Division of Preventive Medicine at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system. Manson is also one of the principal investigators of the Women’s Health Initiative.