Complications (2)
- Osteoporosis
- Menopause weight gain: Stop the middle age spread
Lifestyle and home remedies (4)
- Diabetes and menopause: A twin challenge
- Quit smoking: Proven strategies to help you quit
- Belly fat in women: Taking — and keeping — it off
- see all in Lifestyle and home remedies
Risk factors (1)
- Menopause weight gain: Stop the middle age spread
Symptoms (1)
- Vaginal atrophy
Treatments and drugs (2)
- Hormone replacement therapy and your heart
- Hormone therapy: Is it right for you?
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Hormone replacement therapy and your heart
Are you taking — or considering — hormone therapy to treat bothersome menopausal symptoms? Understand the risks to your heart and how to minimize them.
By Mayo Clinic staffLong-term hormone replacement therapy used to be a routine part of medical care for postmenopausal women. Many women welcomed hormone replacement therapy because it relieves hot flashes and other menopause symptoms.
Hormone replacement therapy was also thought to reduce the risk of heart disease. Around the world, women have a lower risk of heart disease than do men. As women age, though, their heart risk increases, a change that coincides with declining levels of estrogen after menopause. In the 1980s and 1990s, experts advised older women to take estrogen and other hormones as pharmaceuticals in order to retain premenopausal heart health.
It made sense theoretically, but in practice hormone replacement therapy — or hormone therapy, as it's now called — has had mixed results. Many of the hoped-for benefits simply failed to materialize for large numbers of women. The largest randomized, controlled trial to date actually found a slight increase in heart disease, blood clots and strokes in postmenopausal women using hormone therapy.
Risks in perspective
Small as these increases in cardiovascular risks may be, they are not trivial to individual women. But neither are menopause symptoms, for which hormone therapy remains the most effective treatment.
If you're having a tough time with symptoms of menopause but worry about how hormone replacement therapy will affect your heart, try to put your personal risk into perspective. Consider these points:
- The absolute risk of heart disease to an individual woman taking hormone replacement therapy — now called hormone therapy — is quite low. If you experience moderate to severe hot flashes and other menopausal symptoms, the benefits of hormone therapy may outweigh your potential risks.
- Your individual risk of developing heart disease depends on many factors, including family medical history, personal medical history and lifestyle choices. Talk to your doctor about your personal risks. They may not be significant enough to preclude hormone therapy for menopause symptoms.
- If you stopped having periods before age 40 (premature menopause) or lost normal function of your ovaries before age 40 (premature ovarian failure), you have a different set of health risks compared with women who reach menopause near the average age of about 50. This includes a higher risk of coronary heart disease (CHD). And hormone therapy appears to reduce the risk of CHD when started soon after menopause in young women.
If you already have heart disease or you have a history of blood clots, proceed with caution. Work with your doctor to find the safest, most effective treatment for your menopause symptoms.
Next page(1 of 2)
- Martin KA. Postmenopausal hormone therapy: Benefits and risks. http://www.uptodate.com/home/index.html. Accessed Feb. 5, 2010.
- Menopause and hormones. Food and Drug Administration. http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118624.htm. Accessed Feb. 5, 2010.
- Questions and answers about the WHI postmenopausal hormone therapy trials. National Institutes of Health. http://www.nhlbi.nih.gov/whi/whi_faq.htm. Accessed Feb. 5, 2010.
- Martin KA. Treatment of menopausal symptoms with hormone therapy. http://www.uptodate.com/home/index.html. Accessed Feb. 5, 2010.
- Ferri FF. Hot flashes. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/175824536-4/931096584/2088/311.html#4-u1.0-B978-0-323-05609-0..00017-4--s3595_6411. Accessed Feb. 5, 2010.
- Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society. Menopause: The Journal of the North American Menopause Society. 2008;15:584.
- Agepage. http://www.nia.nih.gov/healthinformation/publications/menopause.htm. Accessed Feb. 5, 2010.
- Heart disease: Frequently asked questions. U.S. Department of Health and Human Services: Office on Women's Health. http://www.womenshealth.gov/faq/heart-disease.cfm. Accessed Feb. 5, 2010.
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