A recent analysis suggests that women who undergo hormone replacement therapy (HRT) for a minimum of 10 years before their final menstrual period may experience a reduced risk of developing breast cancer, heart attacks, or strokes. Menopause typically occurs between the ages of 45 and 55 when hormone levels decline, leading to symptoms like irregular periods, hot flashes, mood swings, and sleep disturbances during the perimenopause phase that can last up to a decade before menopause.
HRT, which replaces lost hormones, is available in various forms such as tablets, gels, patches, or sprays containing different hormones like estrogen, progestogen, or both. A study in the US examined the effects of estrogen therapy beyond alleviating perimenopausal symptoms on women’s overall health. The analysis of over 120 million patient records revealed that women on estrogen therapy during perimenopause for at least a decade had a approximately 60% lower risk of breast cancer, heart attacks, or strokes compared to those who started therapy after menopause or did not receive it.
Furthermore, women who initiated treatment post-menopause had a slightly lower risk of breast cancer and heart attacks than those who never used hormones, but they were found to have a 4.9% higher risk of strokes. While HRT may slightly elevate the risk of breast cancer according to the NHS, the overall risk increase is minimal, with approximately five extra cases per 1,000 women using HRT for five years.
Lead author Ify Chidi from Case Western Reserve University School of Medicine highlighted the significance of early initiation of estrogen therapy in potentially reducing morbidity and sparking discussions about preventive measures in women’s health. The National Institute of Health and Care Excellence (Nice) advises caution in prescribing HRT to patients with current, past, or suspected breast cancer, or known estrogen-dependent cancers.
Presented at the annual Menopause Society meeting in Orlando, the study findings suggest a lower risk and potential benefits of estrogen-based therapy when started during perimenopause. Dr. Stephanie Faubion, medical director at the Menopause Society, emphasized the importance of further research on the risks and benefits of hormone therapy when initiated earlier in menopausal transition.
Dr. Kotryna Temcinaite from Breast Cancer Now emphasized that the decision to start HRT for menopausal symptoms is personal and noted that the risk of breast cancer due to HRT is generally low. Ongoing discussions are focused on the health impacts and timing of estrogen-only HRT, highlighting the need for better understanding of its effects.
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