Women under 60 who’ve recently transitioned into menopause should continue being offered hormone therapy to relieve some of their symptoms, including hot flashes and night sweats, according to findings from a major study published this month in JAMA, the journal of the American Medical Association.
When used in menopause — a term that means someone has gone a full year without having a menstrual period — hormone therapy involves taking estrogen, often in combination with progestin, to help make up for what’s lost when menstruation stops and the ovaries are no longer producing hormones. In the US, the average age of menopause is 51.
Though the study doesn’t support the use of hormone therapy for reducing the risk of heart disease or other chronic diseases, as has been suggested in some earlier studies, the findings are significant for a couple of reasons. They included information from the Women’s Health Initiative, the largest clinical study of women in the US, which enrolled thousands of women of menopausal age and has followed them for years, studying different aspects of health, like cardiovascular health and other disease risk.
Discussions over the use of hormonal therapy were clouded years earlier, however, when reports from the same ongoing study linked adverse health events in older women to the therapy, prompting many people to lose access to or guidance toward the treatment, without an adequate alternative to relieve some menopause symptoms that can greatly impact quality of life.
The latest findings confirm that, for many women early in their menopause years, the benefits of hormone therapy in relieving distressing symptoms such as hot flashes, night sweats and genital and urinary tract problems, outweigh the risks.
Read more: 4 Ways Fitness Is Key to Healthy Aging, and How to Start
What is hormone therapy?
Hormone therapy, or hormone replacement therapy, is a general term that describes someone taking synthetic versions of the hormones the body produces naturally.
When used for menopause, hormone therapy delivers estrogen to ease symptoms like hot flashes, night sweats, and urinary and genital discomfort that come as the body adjusts to sharp decreases in hormone levels. Progestin is used in combination with estrogen if someone still has their uterus and hasn’t had a hysterectomy, according to the American College of Obstetricians and Gynecologists, because it reduces the risk of uterine cancer when estrogen alone is used.
Read more: Multivitamins, Memory and Aging: Everything to Know
Who should get hormone therapy for menopause?
The latest study confirms what many reproductive health experts and medical bodies have said about hormonal therapy: that it’s effective for treating many of the side effects of menopause that may disrupt sleep, cause stress or interrupt quality of life. However, risks and benefits depend on when someone starts treatment and their individual risk factors. People who’ve had certain cancers or have blood clotting or stroke risks, for example, may have higher risks, but you should discuss your individual case with your doctor because there are different forms hormones come in these days, with varying risk profiles.
According to the Cleveland Clinic, most studies (which now include the one from this month) support starting hormone therapy closer to the onset of menopause (early 50s, for many people), as opposed to waiting. People who go through early menopause or lose their estrogen sooner may require hormone therapy, the Clinic notes.
What else to know about the study
The latest findings from the Women’s Health Initiative didn’t support hormone therapy as a way to reduce the risk of cardiovascular disease risk or to improve heart health.
Engaging in things that are generally good for your heart, like regular physical activity, eating a heart-healthy diet, not smoking and keeping tabs on your blood pressure and cholesterol are helpful during menopause, as well as at any point in your life.
The study also didn’t find support for extra calcium or vitamin D supplementation as a way to ward off fractures, which are more common during menopause because lack of estrogen directly impacts bone health. However, for people who don’t get enough calcium or vitamin D in their diet naturally, supplementing may be useful, something health experts will tell you is already the general rule for who needs a supplement.
