Bharti Jayshankar
November 29, 2024: Certain hormone replacement therapy (HRT) pills significantly elevate the risk of heart disease and serious blood clots in menopausal women, according to a recent study.
Researchers found that estrogen/progestin pills and tibolone present alarming health risks, prompting calls for further investigation into HRT’s cardiovascular effects. Researchers discovered that estrogen/progestin pills increased the risk of heart disease by 21% and life-threatening blood clots by 61%. Furthermore, the synthetic hormone tibolone was found to elevate heart disease risk by 46% and nearly double the likelihood of stroke and heart attack, although it did not increase the risk of blood clots.
Increased heart disease risk
The research team, led by Therese Johansson from Uppsala University in Sweden, analyzed data from over 919,000 healthy women aged 50 to 58 between 2007 and 2020. They categorized participants based on their HRT usage and monitored them for two years. The findings revealed that women taking oral estrogen/progestin or tibolone faced an increased risk of heart disease, translating to approximately 11 new cases per 1,000 women treated for one year. In contrast, hormone therapies administered through patches or gels did not show an increased risk for heart disease but did raise the potential for dangerous blood clots.
Tibolone is not currently approved in the United States and its use has been declining in Sweden. Despite its risks, researchers noted that approximately 1,000 women initiated tibolone therapy in 2018 alone, which was linked to an estimated one incident of stroke or heart disease. The study underscores the need for more research to clarify how different forms of hormone therapy affect cardiovascular health.
While HRT is commonly prescribed to alleviate menopausal symptoms such as hot flashes and night sweats, the potential cardiovascular risks cannot be overlooked. The study highlights that hormones like estrogen taken orally are metabolized in the liver, potentially increasing blood coagulant production and thus raising clotting risks.
HRT history
Hormone replacement therapy has long been utilized to manage symptoms associated with menopause. However, its relationship with cardiovascular health has been contentious. The last twenty years have seen doctors hesitating to prescribe HRT for menopausal women as a major study, Women’s Health Initiative (WHI) in 2002, showed it to be detrimental to women’s health.
Observational studies have shown mixed results regarding HRT’s effects on coronary heart disease (CHD), often depending on factors like age at initiation and time since menopause onset. In light of these recent findings, it is crucial for women considering HRT to engage in informed discussions with their healthcare providers about their health profiles and potential risks associated with different types of hormone therapies.
