A 10-Million Women Study Shows HRT Can Help Women Over 65

[Nelson Vergel]

Introduction​

For many years, it was believed that hormone therapy (HT) for menopausal symptoms was unnecessary after age 65 because symptoms rarely persisted beyond this age. However, recent evidence shows that many older women continue to experience these symptoms, and HT can still be beneficial for them. In 2022, The Menopause Society updated their guidelines, suggesting that the decision to start or continue HT after age 65 should be based on each woman's specific needs, overall health, and medical history. They also recommended using lower doses and non-oral forms of HT to reduce the risk of side effects.

Study Overview​

This study examined the use of HT in women over 65 and its effects on various health outcomes. We analyzed 40 different types of HT and their impact on 13 health conditions. The results showed significant differences depending on the type, method, and dosage of HT used.

Key Findings​

Mortality Risk​

Women who continued to use estrogen therapy (ET) after age 65 had a significantly lower risk of dying from any cause. They also had lower risks of developing breast, lung, and colorectal cancers, as well as heart conditions like congestive heart failure (CHF), venous thromboembolism (VTE), atrial fibrillation (AF), and heart attacks (AMI), and dementia. The risk reduction was greater with certain types of estrogen (E2 vs. CEE), non-oral methods (vaginal and transdermal vs. oral), and lower or medium doses.

Cancer Risks​

Using estrogen therapy (ET) alone was linked to a lower risk of breast, lung, and colorectal cancers. However, using estrogen plus progestin therapy (EPT) slightly increased the risk of breast cancer but showed some protective effects against endometrial and ovarian cancers and certain heart conditions.

Cardiovascular Diseases and Dementia​

Medium doses of oral CEE did not reduce the risk of heart diseases or dementia and were linked to increased risks of heart disease and stroke. In contrast, low-dose ET significantly reduced these risks. Non-oral forms of ET also lowered the risks of dementia and stroke.

Strengths and Limitations​

This study had a large sample size, including over 10 million women, which provided robust data. However, it relied on prescription records and could not verify medical conditions through chart reviews. The study's strengths include its size and the use of prescription records rather than patient recall.

Conclusion​

The study suggests that HT can provide significant health benefits for women over 65. Estrogen therapy alone can reduce the risk of mortality, various cancers, heart conditions, and dementia. The benefits of estrogen plus progestin therapy are less clear and may increase breast cancer risk. Overall, lower doses and non-oral methods of HT are generally safer and more effective. These findings support the idea that HT should be tailored to each woman's needs and health profile.

Source:

Use of menopausal hormone therapy beyond age 65 years and... : Menopause

en from 2007-2020 and Cox regression analyses adjusted for time-varying characteristics of the women, we examined the effects of different preparations of menopausal hormone therapy on all-cause mortality, five cancers, six cardiovascular diseases, and dementia. Results Compared with never use...

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