Hormone tablets taken during menopause provide relief from symptoms, but do they have long-term health risks? Researchers have found that hormone replacement therapy (HRT) tablets containing both estrogen and progestogen may increase the risk of heart disease and blood clots in menopausal women.
During menopause, women's body goes through a series of changes due to a decrease in female hormones, progesterone, and estrogen resulting in symptoms such as hot flashes, mood swings, night sweats, insomnia, and vaginal dryness. These symptoms are often frustrating, interfering with their daily lives and mental well-being.
HRT was once commonly prescribed for menopausal symptoms and to reduce the risk of bone loss during this stage. However, recent studies pointing to long-term risks have led to a more cautious approach. It is now recommended only for those where the benefits outweigh the risks. The estimate shows that only 5% of women in the U.S. use it now, a significant drop from about 27% two decades ago.
The latest study published in The BMJ examined the effects of HRT tablets on heart health based on the route of administration and the combination of hormones used. The study suggests that tablets containing both estrogen and progesterone, such as oral combined continuous, oral combined sequential, oral unopposed estrogen, and transdermal combined therapy, increased the risk of ischemic heart disease and venous thromboembolism (blood clots) in women.
The researchers also found that the tablet tibolone in particular was linked to a higher risk of heart disease, heart attack, and stroke, but not blood clots. Tibolone is a synthetic hormone that contains estrogen, progesterone, and testosterone.
"Compared with not starting menopausal hormone therapy, starting oral combined continuous therapy or tibolone was associated with an increased risk of ischemic heart disease," the news release stated.
"If 1,000 women started each of these treatments and were observed for a year, we would expect to see seven new cases of venous thromboembolism across all groups," the researchers wrote.
However, there was no increased risk associated with transdermal treatments such as skin patches, gels, and creams.
The researchers caution that the study does not prove that HRT causes heart health risks, as the findings are based on observational data. Also, the lack of information on menopausal status and other unmeasured factors, such as smoking and body mass index, may have influenced the results.
