Menopausal Hormone Therapy Use Beyond 65 Years Beneficial

TUESDAY, April 16, 2024 (HealthDay News) -- Use of menopausal hormone therapy beyond age 65 years is associated with risk reductions in mortality as well as specific cancers and cardiovascular diseases, according to a study published online April 9 in Menopause.

Seo H. Baik, Ph.D., from the U.S. National Institutes of Health in Bethesda, Maryland, and colleagues examined the effects of different preparations of menopausal hormone therapy on all-cause mortality, five cancers, six cardiovascular diseases, and dementia using data for 10 million senior Medicare women.

The researchers found that the use of estrogen monotherapy beyond age 65 years was associated with significant risk reductions in mortality (19 percent), breast cancer (16 percent), lung cancer (13 percent), colorectal cancer (12 percent), congestive heart failure (CHF; 5 percent), venous thromboembolism (3 percent), atrial fibrillation (4 percent), acute myocardial infarction (11 percent), and dementia (2 percent) compared with never use or discontinuation beyond age 65 years. Both estrogen plus progestin and estrogen plus progesterone were associated with a 10 to 19 percent increased risk for breast cancer; use of low-dose transdermal or vaginal estrogen plus progestin could mitigate this risk. Significant risk reductions were seen in endometrial cancer, ovarian cancer, ischemic heart disease, CHF, and venous thromboembolism (45, 21, 5, 5, and 5 percent, respectively) with estrogen plus progestin, while risk reduction was only seen in CHF with estrogen plus progesterone (4 percent).

"This large observational study of women in Medicare provides reassurance regarding the safety of longer-term hormone therapy use and even potential benefits, particularly in women using estrogen alone," Stephanie Faubion, M.D., medical director of The Menopause Society, said in a statement. "It also offers important insights into variations among different hormone therapy doses, routes of administration, and formulations that could facilitate individualization of treatment."

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