Mortality associated with hormone replacement therapy in younger and older women

Abstract

Hormone replacement therapy reduced total mortality in trials with mean age of participants under 60 years. No change in mortality was seen in trials with mean age over 60 years.

Hot flushes, hormone therapy and alternative treatments: 30 years of experience from Sweden

“…On the other hand a recent study suggests that women with early onset of HT after menopause are at higher risk of breast cancer than women with delayed onset (46). Also, a meta-analysis of 23 randomized, controlled trials showed a significant reduction of cardiac events in women with early menopause using HT (47). Other interesting findings in the risk/benefit evaluation are the possible relation between HF and increased risk of CVD (48).…”

“…Other interesting findings in the risk/benefit evaluation are the possible relation between HF and increased risk of CVD (48). Furthermore, if HT is initiated before the age of 60, a significant reduction in all-cause mortality is seen compared to mortality in the group on placebo (47). If women were better informed about these results this might lead to a wider acceptance of estrogen therapy in postmenopausal women (49).…”

Is HRT still indicated for the primary prevention of osteoporosis?

“…There is no increase in total all-cause mortality in women using HRT [33], as might be the case if there were a significant increase in the risk of CVD and breast cancer. In contrast, in younger women (50-60 years, or starting HRT less than 10 years after menopause), a recent metaanalysis [33] suggests a significantly decreased risk of all-cause mortality.…”

“…In contrast, in younger women (50-60 years, or starting HRT less than 10 years after menopause), a recent metaanalysis [33] suggests a significantly decreased risk of all-cause mortality. This supports the 'window of opportunity' theory where early use of HRT is associated with preventative cardiovascular benefits and is in agreement with the latest data from both the WHI and the Nurses' Health Study.…”

O uso da TH após a menopausa promove benefícios?

“…3 constatou-se exatamente o contrário, ou seja, a TH se associava a uma maior morbimortalidade independente da faixa etária, o que culminou na orientação de que sua prescrição só deveria ser feita para curtos períodos e exclusivamente para sintomas menopausais 4,5 . A partir daí, muitas mulheres suspenderam abruptamente a TH, resultando numa significativa piora na qualidade de vida 6 .…”