Menopause Hormone Treatment Linked to Reduced Heart Events in Certain Groups
A target trial emulation of observational data indicated that initiating menopausal hormone therapy was associated with a 22% reduction in cardiovascular events among perimenopausal and recently postmenopausal women with vasomotor symptoms. The benefit was stronger for those who started therapy within 10 years of menopause onset and for Black women, but no clear benefit was seen for other groups. The authors cautioned that the findings should not be used to support hormone therapy for cardiovascular prevention.
The study's findings contrast with the Women's Health Initiative, which previously drove boxed warnings on hormone therapies. Notably, the FDA recently removed those warnings for six products. The current analysis also flagged a higher breast cancer risk among initiators, though venous thromboembolism rates showed no significant difference.
Researchers noted their cohort included younger women starting therapy during perimenopause or early postmenopause. An accompanying commentary highlighted that cardiovascular effects remain poorly characterized due to the wide variety of hormone preparations and delivery routes, including oral contraceptives with higher estrogen doses.
This evidence could refine clinical conversations, allowing providers to weigh individualized risks and benefits for symptom relief. It may also reduce stigma around hormone therapy for certain groups, though the lack of consistent benefit for cardiovascular prevention means it should not alter standard prescribing guidelines. The findings could influence future research directions and regulatory considerations.