A U.S. Preventive Services Task Force (USPSTF), an independent group of health experts, convened at the request of Congress, first hinted that hormone replacement therapy (HRT) might be too risky for long-term use in 2005. Based on the available data at that time, the task force warned women to avoid using HRT for preventing chronic conditions, such as heart disease and dementia. There were earlier studies that had suggested that the supplemental hormones some women take to relieve night sweats and “hot flashes” associated with menopause could also protect the heart and brain from age-related decline.
Following the results of a Women’s Health Initiative (WHI) study a decade ago, the use of HRT in the prevention of chronic conditions such as heart disease, dementia and osteoporosis dropped considerably. Between January 2002 and November 2011, nine different trials were conducted. The task force analyzed 51 reports from these studies, confirming their earlier findings that the risks of the therapies outweighed the benefits. The study found little difference in the rate of heart disease among women who used HRT and those who did not. Instead, it reported that HRT might increase the risk of heart disease and breast cancer.
Estrogen plus progestin, as well as estrogen alone, moderately reduced the risk of bone fractures, however, it increased the risk for stroke, thromboembolic events (deep vein blood clots), gallbladder disease and urinary incontinence. Estrogen plus progestin increased the risk for breast cancer and dementia, while estrogen alone decreased the risk for breast cancer.
The report conflicts with a recent study published in the British Medical Journal suggesting that age may play a role in the effects of HRT. In their study of more than 1,000 Danish women who had recently entered menopause, researchers found that women treated with long-term HRT early after menopause “had significantly reduced risk of mortality, heart failure or heart attack.”
In its most recent analysis published online in the Annals of Internal Medicine, the USPSTF confirmed its previous findings that the risk of HRT outweigh the possible benefits. Overall, the data shows that HRT, which combines estrogen and progestin, is linked to an increased risk of stroke, blood clots, gallbladder disease, urinary incontinence, dementia, and breast cancer. It is reported that even among women who have undergone hysterectomy, the risks remain significant.
Still, this recommendation isn’t likely to be the final word on HRT. The task force says that more research is needed regarding the use of HRT among women who are transitioning through menopause, as well as the effects the hormones can have on women of different ages.
(Of note, the average age of the women involved in the WHI trial who found no long-term benefits averaged 64 years of age, which, the panel states, is “largely past the point of menopausal onset.”)
Major health organizations such as the American Heart Association, the American Congress of Obstetricians and Gynecologists and the American Academy of Family Physicians also recommend against long-term HRT use in post-menopausal women to treat conditions other than menopausal symptoms.
We will keep you updated as new data becomes available. Feel free to contact one of our Gacovino Lake attorneys at 1-800-246-HURT (4878).
