No increased risks for heart disease or type 2 diabetes with hormone therapy use in middle-aged postmenopausal women

 Although hormone therapy (HT) remains the most effective treatment for menopause symptoms, some women have hesitated to use it because of concerns about various adverse health effects. A new study, however, is reducing some of those concerns, showing no increased risk of heart disease or type 2 diabetes relative to HT use. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).

Over the years, the pros and cons of HT have been hotly debated. Although some controlled trials had previously found that HT was associated with an increased risk of heart disease, current guidelines suggest that HT is safe for appropriate patients who have been evaluated for baseline diseases, their age, and the timing of initiation. A challenge with many of the older studies is that they included older menopausal women with underlying cardiovascular risk factors and who had been menopausal for a long time. Most of these studies did not consider type 2 diabetes as a primary outcome. Nor did they account for age, duration since menopause, preexisting pathology, and different ethnicities.

In this new study, which gathered data from the National Health Insurance database in Korea on more than 58,000 postmenopausal women, researchers investigated the association of HT with heart disease and type 2 diabetes in middle-aged postmenopausal women selected according to the current guidelines. They concluded, on the basis of their results, that HT is not significantly associated with heart disease or type 2 diabetes. Such results may go a long way in helping to reduce the lingering concerns about the use of hormones for middle-aged postmenopausal women.

Study results are published in the article “Effects of menopausal hormone therapy on cardiovascular diseases and type 2 diabetes in middle-aged postmenopausal women: analysis of the Korea National Health Insurance Service Database.”

“These results are consistent with our current understanding of the risks and benefits of hormone therapy, with the benefits typically outweighing the risks for women who initiate hormone therapy aged younger than 60 years and within 10 years of menopause onset,” says Dr. Stephanie Faubion, NAMS medical director.