We Need To Rethink Hormone Replacement In Women

A recent Danish study shows that 10 years of hormone replacement started early in menopause significantly improved cardiovascular risk (50% reduction).  A few years ago America was floored by the Women’s Health Initiative’s results which suggested no cardiovascular benefit and an additional cost of increased breast cancer risk. That information caused the doctors and patients to make an about-face and withdraw all hormone replacement as well as not offer any replacement when menopause started. This 10 year treatment trial with an additional 6 years of followup show no demonstrable increase in cancer but a 50% drop in cardiovascular rates.  I recommend readers read a more detailed newsletter from HeartWire for more details.

In my practice over the years I have noticed that the women who took early and persistent hormone replacement appeared more youthful than their counterparts. Anecdotely I have also noticed that in whenever I occasionally note a women’t bone density is far better then predicted, the patient started hormone replacement early in their menopause history.

Bottom Line:  This study is going to put a monkey-wrench in the gynecology recommendations about hormone replacement. Women’s doctors are going to have to rethink the recent past reflex”legal concerned”  about face decision to not provide hormone replacement and consider quality of life as well as perhaps the unrecognized health benefits of early hormone replacement in women going through menopause.  This study was powered enough to provide meaningful information albeit it was far smaller than the Women’s Health Initiative.