Data from the WHI for women who received estrogen alone because they were post-hysterectomy also support cardiac benefit. With good gynecologic follow-up, the use of progesterone to decrease risk of endometrial cancer may not be justified. The initial WHI reporting frightened millions of women and their physicians -- the resulting misconception has likely resulted in decreased cardiac and bone health for these patients -- and should be addressed in clear and widely published reports by the WHI Investigators.
New Data Suggest Safety of Hormone Therapy in Early Menopause — Physician’s First Watch
New Data Suggest Safety of Hormone Therapy in Early Menopause
In early menopause, 10 years of hormone therapy might lower the risk for cardiac events without raising the risk for cancer, thrombosis, or stroke, according to an open-label study in BMJ.
Roughly 1000 newly menopausal women (mean age, 50) in Denmark were randomized to hormone therapy (estradiol plus norethisterone acetate for those with an intact uterus, estradiol alone for those posthysterectomy) or to no treatment. The intervention was stopped at 10 years, after the Women's Health Initiative reported HT-associated harms.
At the end of treatment, the primary outcome — a composite of death, MI, or heart failure — was less common among women on HT; this significant benefit persisted through 16 years' total follow-up. Risks for thrombosis, stroke, and cancer did not differ between the groups. Speculating on why these results differ from the WHI's findings, the researchers point to the younger age of the current cohort and the different hormones used.
Andrew Kaunitz of Journal Watch Women's Health said: "Taken together with findings from a subanalysis of younger women from the WHI, these data should reassure clinicians and women that use of hormone therapy in recently menopausal women is safe."