Unlocking Heart Health: How Hormone Therapy Can Benefit Menopausal Women

Deciding to start hormone therapy during the menopause transition can be a tricky choice. This phase marks the end of a woman’s menstrual cycle and comes with various symptoms, like hot flashes and night sweats. Hormone therapy aims to alleviate these symptoms by replacing hormones that the body no longer produces. However, there’s chatter about the long-term impacts of this therapy, especially regarding heart health.

Matthew Nudy, an assistant professor at Penn State College of Medicine, emphasizes that many people are confused about how hormone therapy affects cardiovascular health. He recently led a study looking into this very issue. The findings, published in Obstetrics & Gynecology, indicate that estrogen-based hormone therapy can actually improve heart health markers over time.

Researchers examined data from the Women’s Health Initiative, a comprehensive study on menopausal women. They discovered that hormone therapy could lower lipoprotein(a), a genetic risk factor linked to heart attacks and strokes. This study adds vital information to a topic often debated among patients and healthcare providers.

Nudy mentioned, "The pendulum has been swinging back and forth as to whether hormone therapy is safe for menopausal women, especially from a cardiovascular disease perspective.” But recent findings show that younger menopausal women—especially those who are generally healthy—may benefit from hormone therapy.

As menopause sets in, declining estrogen levels can contribute to health issues like increased heart disease risks. Hormonal changes impact cholesterol, blood pressure, and plaque buildup in vessels.

The research team focused on the long-term effects of hormone therapy on cardiovascular health, analyzing data from women who participated in an earlier trial. Participants were divided into two groups: one receiving estrogen-only treatment and the other receiving estrogen with progesterone. Their samples were collected over six years, involving around 2,700 women of various backgrounds.

The results were promising. Hormone therapy users showed reduced levels of bad cholesterol (LDL) and improved good cholesterol (HDL). Interestingly, both groups tracked a notable decrease in lipoprotein(a) levels over time—15% for those on estrogen only and 20% for those on the combined therapy.

One fascinating aspect of the research was the ethnic differences observed. Participants with ancestry such as American Indian, Alaska Native, Asian, or Pacific Islander displayed even more significant reductions in lipoprotein(a) levels. Nudy expressed hope to explore these findings further in future studies.

However, Nudy cautioned about other effects. Some markers like triglycerides increased, which may be due to how oral hormone therapy is processed in the liver. He mentioned newer forms of estrogen therapy, like transdermal (skin patches), which don’t show the same rise in triglycerides or inflammatory markers, making them potentially safer options.

Before starting hormone therapy, he suggests women assess their cardiovascular disease risks, even if they have no history of heart problems. "Currently, hormone therapy isn’t approved by the FDA to prevent coronary artery disease or stroke," Nudy reminded.

In a world where 1 in 3 women will experience heart disease, understanding how menopause treatments may influence heart health is crucial. As attitudes toward hormone therapy continue to evolve, informed decisions can help improve the quality of life for many women navigating menopause.

For more detailed insights into this ongoing research, check out the study by Nudy et al. in Obstetrics & Gynecology here.

Source link