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New Data Suggest Safety of Hormone Therapy in Early Menopause

In early menopause, 10 years of hormone therapy might lower the risk for cardiac events without raising the risk for cancer, thrombosis, or stroke, according to an open-label study in BMJ.

Roughly 1000 newly menopausal women (mean age, 50) in Denmark were randomized to hormone therapy (estradiol plus norethisterone acetate for those with an intact uterus, estradiol alone for those posthysterectomy) or to no treatment. The intervention was stopped at 10 years, after the Women's Health Initiative reported HT-associated harms.

At the end of treatment, the primary outcome — a composite of death, MI, or heart failure — was less common among women on HT; this significant benefit persisted through 16 years' total follow-up. Risks for thrombosis, stroke, and cancer did not differ between the groups. Speculating on why these results differ from the WHI's findings, the researchers point to the younger age of the current cohort and the different hormones used.

Andrew Kaunitz of Journal Watch Women's Health said: "Taken together with findings from a subanalysis of younger women from the WHI, these data should reassure clinicians and women that use of hormone therapy in recently menopausal women is safe."

LINK(S):

BMJ article (Free)

Background: Physician's First Watch coverage of recent study on short-term HT for early menopausal symptoms (Free)

Background: Journal Watch Women's Health summary on subanalysis of younger WHI participants (Your Journal Watch registration required)

Published in Physician's First Watch October 10, 2012

Reader Remarks:

Review and add to remarks on this article

• HRT safety and benefit
  Judith C Andersen, Karmanos Cancer Institute, 10 Oct 2012 12:03 PM EST
  Specialty: Hematology/Oncology
  Data from the WHI for women who received estrogen alone because they were post-hysterectomy also support cardiac benefit. With good... [more]