Hormone Therapy Reduces Hot Flashes Without Increasing Heart Risks in Younger Women

Recent findings from the National Heart, Lung, and Blood Institute highlight that menopausal hormone therapy can effectively alleviate vasomotor symptoms such as hot flashes and night sweats in women experiencing menopause, especially in younger age groups, without elevating their risk of cardiovascular disease. The study analyzed data from two large hormone therapy trials involving over 27,000 postmenopausal women aged 50 to 79 across the United States.

Participants with moderate to severe vasomotor symptoms were given either conjugated equine estrogens (CEE) alone or CEE combined with medroxyprogesterone acetate (MPA), or a placebo. The median follow-up was approximately 7.2 years for the CEE group and 5.6 years for the CEE plus MPA group. Results showed that CEE alone reduced hot flashes by 41%, while CEE combined with MPA provided similar relief, mainly in women aged 50 to 59. The benefits diminished in women aged 70 and above.

Importantly, in women aged 50 to 59, hormone therapy did not increase the risk of cardiovascular events, even in those with moderate or severe symptoms. However, in women aged 70 and older, hormone therapy was associated with a significantly higher incidence of cardiovascular problems, with hazard ratios nearly double and more than triple, respectively.

These findings suggest that hormone therapy can be a safe and effective option for treating vasomotor symptoms in younger women, but caution is advised for women aged 60 and above due to increased cardiovascular risks. Initiating therapy in women over 70 is generally not recommended based on these results.

The study offers a clearer perspective on hormone therapy safety, addressing longstanding concerns about its cardiovascular effects, and reinforces that age and health status are crucial factors in treatment decisions.

For more detailed information, the full study is published in JAMA Internal Medicine, providing valuable insights into the nuanced risks and benefits of menopausal hormone therapy.