Taking hormones for menopause doesn’t raise early death risk: study

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(TCTMD) — Women who choose to take hormone therapy—whether estrogen alone or in combination with progestin—to curb menopausal symptoms have no higher or lower long-term risks of all-cause, cardiovascular, or cancer mortality than women who don’t take the drugs, according to long-term follow-up from the two Women’s Health Initiative (WHI) trials. Among individuals who start therapy in their 50s, there are also hints of a survival benefit.

The findings, from over 18 years of cumulative follow-up among more than 27,000 participants in the WHI studies, were published September 12, 2017, in the Journal of the American Medical Association.

“All-cause mortality is a critically important summary measure,” lead author JoAnn E. Manson, MD, DrPH (Brigham and Women’s Hospital, Boston, MA), told TCTMD. “It’s the ultimate bottom line when looking at the net effect of a medication on serious and life-threatening health outcomes. And this is particularly relevant to menopausal hormone therapy, which has a complex pattern of benefits and risks.

“We know that it’s effective for treating hot flashes and menopausal symptoms. It reduces hip fracture, other fractures, and it seems to decrease the risk of diabetes. But it also has been linked to increased risks of venous blood clots, stroke, and some cancers,” she continued. On that background, she said, the current results are “reassuring.”

Melissa McNeil, MD, MPH (University of Pittsburgh, PA), who wrote an editorial accompanying the paper, agreed that the news is positive and observed to TCTMD that the findings support current practice. (…)

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