HRT can cut risk of early death for women in middle age

Hormone treatment does not increase danger of cancer, says new US study

HORMONE replacement therapy can cut the risk of early death in middle-aged women by almost a third.

Scientists have discovered that patients given HRT also had healthier hearts and were no more likely to get cancer or other potentially fatal illnesses than those given a placebo.

Researchers followed 27,347 women for 18 years who were prescribed HRT to combat hot flushes and other symptoms of the menopause.

Those given oestrogenonly HRT had significantly lower deaths from dementia, the study by the Division of Preventive Medicine at Brigham and Women’s Hospital, Boston, found.

Dr Joann Manson, the lead author, said the findings, published in the Journal of the American Medical Association (JAMA), supported clinical guidelines endorsing the use of HRT.

The proportion of women taking up HRT has dropped significantly over the past two decades since reports that it can lead to a greater risk of certain cancers in some people.

But the latest findings published in JAMA are based on a greater number of patients over a longer period than most comparable studies.

The British Heart Foundation said the research should reassure women.

Dr Mike Knapton, associate medical director at the British Heart Foundation, said: “The concern with all medication is whether the short-term benefits mean sacrificing your long-term health. Hormone replacement therapy is commonly prescribed to women as it is effective at reducing menopausal symptoms.

“This study found no association between taking hormone replacement therapy and mortality.

“This should reassure women and doctors that taking HRT does not increase your risk of dying from heart and circulatory disease or cancer.”

Dr Manson said: “Mortality rates are the ultimate ‘bottom line’ when assessing the net effect of a medication on serious and life-threatening health outcomes.”

The study tested the most common formulations – oestrogen and progestin, and oestrogen alone – to assess the benefits and risks of HRT in two Women’s Health Initiative

‘Mortality rates are the ultimate “bottom line” when assessing the net effect’

(WHI) trials in the US.

Overall, there was no change in total mortality, or death rates, among the participants, aged 50 to 79, from cardiovascular disease, cancer or other major illnesses.

They were selected at random either to receive HRT or the placebo.

The team also found that deaths from Alzheimer’s disease and other forms of dementia were significantly lower with oestrogen-only HRT, rather than combined with progestin, which was not associated with dementia mortality.

The researchers said it is important to note in current clinical practice that lower doses, different formulations and new administration methods such as skin patches, gels or sprays are now common. Additional research on the long-term benefits and risks of these newer treatments is needed, they added.