Women who have recently transitioned into menopause under the age of 60 should continue to be offered hormone therapy to relieve symptoms such as hot flashes, night sweats, and other discomforts. Hormone therapy involves taking estrogen, sometimes in combination with progestin, to compensate for the loss of hormones when menstruation ceases and the ovaries stop producing hormones. The study, published in JAMA, is based on information from the Women’s Health Initiative, the largest clinical study of women in the US, which has followed menopausal women for years to study various aspects of health. While the study does not support using hormone therapy to reduce the risk of heart disease or other chronic diseases, it confirms the benefits of hormone therapy for relieving distressing menopause symptoms in many women.
Hormone therapy, also known as hormone replacement therapy, involves taking synthetic versions of naturally produced hormones. When used for menopause, hormone therapy delivers estrogen to alleviate symptoms like hot flashes, night sweats, and urinary and genital discomfort that occur due to hormonal imbalances. Progestin may be added if the individual still has a uterus, to reduce the risk of uterine cancer when estrogen alone is used. The decision to start hormone therapy depends on individual risk factors, and people with certain medical conditions may have higher risks. Starting hormone therapy closer to the onset of menopause, generally in the early 50s, is recommended, as early menopause or estrogen loss may necessitate treatment.
Reproductive health experts and medical bodies assert that hormone therapy is effective in treating menopausal symptoms that can disrupt sleep, cause stress, or impact quality of life. However, the risks and benefits vary based on the individual and when treatment begins. Most studies align with the recent findings in supporting the initiation of hormone therapy around the early 50s for optimal results. While hormone therapy may not reduce the risk of cardiovascular disease or improve heart health, engaging in heart-healthy habits such as regular physical activity, a nutritious diet, quitting smoking, and managing blood pressure and cholesterol is beneficial during menopause. Additionally, extra calcium or vitamin D supplementation may be necessary for individuals with insufficient dietary intake.
The study did not find evidence supporting hormone therapy as a preventive measure for cardiovascular disease or as a means to enhance heart health. In cases of menopause-related fractures, which are more common due to decreased estrogen levels impacting bone health, extra calcium or vitamin D supplementation may not be effective for everyone. However, supplementing with calcium or vitamin D may be beneficial for individuals with dietary deficiencies in these nutrients. Women who have undergone early menopause or experience estrogen loss sooner may require hormone therapy, as indicated by the Cleveland Clinic. It is advisable to consult with a healthcare provider to discuss individual risk factors and determine the most suitable treatment approach for menopausal symptoms.
