Leading Experts Agree on Hormone Therapy Benefits/Risks

With so many research studies on the use of hormone therapy (HT) to alleviate menopause symptoms, can medical researchers now agree on whether the benefits of hormone therapy outweigh the reported increased risk of developing cancer? Late last year, the Society for Women’s Health Research (SWHR) convened a panel of eighteen recognized experts to review the most current evidence to see if a research-based consensus could be reached.

It was a distinguished group that included two principal investigators of the Kronos Early Estrogen Prevention (KEEPS) Study; Dr. Mitchell Harman, Director and President of the Kronos Longevity Research Institute; and Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital, who presented the initial results of that study last Fall. She reported that estrogen/progesterone treatment, (conjugated equine estrogen alone or with MPA) started soon after the onset of menopause, appears safe and relieves many of the symptoms menopausal women face as well as improving mood and markers of cardiovascular risk.

But according to the SWHR, many scientists don’t agree with some of the recent findings and the inconsistencies among the reports, that have caused women to remain fearful of hormone use, more than a decade after the Women’s Health Initiative (WHI) Study was abruptly halted. That study found that post-menopausal women taking HT were at an increased risk of invasive breast cancer, heart attack, stroke, pulmonary emboli, deep vein thrombosis and dementia.

The good news is that, with some caveats (explained in the clinical statement that you can read here), there was mostly unanimous agreement in five areas:  cardiovascular disease, Alzheimer’s disease and cognitive aging, osteoporosis, cancer and quality of life.  Here are the highlights of their statement:

• The benefit/risk profile of hormone therapy is more favorable for younger, newly menopausal women. (Click here to share this statement with your Twitter followers.)
• For younger post-menopausal women without a uterus, the benefits of estrogen-only treatment for at least ten years outweigh the risks.
• Hormone therapy is the most effective treatment for vasomotor symptoms (hot flashes).
• In post-menopausal women who have had a hysterectomy, estrogen-only doesn’t appear to increase the risk of breast cancer and may possibly reduce the risk.
• Hormone therapy “does not increase and may reduce” total mortality.
• There is insufficient evidence that to recommend Hormone Therapy after menopause for the prevention of dementia or enhancement of cognition.
• Hormone therapy in early postmenopausal women does not increase the risk for coronary heart disease and may reduce it. (click here to share this statement with your Twitter followers)
• Hormone therapy in early, postmenopausal women may slightly increase the risk of stroke, although the absolute increase in risk, if present, is very small. (3 members of the panel wanted to emphasize that the risk, if present, is “rare” rather than “small.”