Hormone Therapy and Aging

“For women who initiate HT more than 10 or 20 years from menopause onset or when aged 60 years or older, the benefit-risk ratio appears less favorable than for…”.1

Umbrella
What may the Hormone Therapy and Aging Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Hormone Replacement Therapy (HRT) and Aging/Prevention/Protection
  • Hormone Therapy (HT) and Aging/Prevention/Protection
  • Menopausal Hormone Therapy (MHT) and Aging/Prevention/Protection

Chronic Conditions

Is there an association between hormone therapy (HT) and the prevention of chronic conditions?

In December 2017, the (United States) Preventative Services Task Force (USPSTF) updated their 2012 recommendations about the use of HT in postmenopausal women for the primary prevention of chronic conditions.

Hormone Therapy and AgingIn Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions – Recommendation Summary the USPSTF recommend:

“Postmenopausal women
The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal women”.2

Hormone Therapy and AgingIn Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions – Recommendation Summary, the USPSTF recommend:

“Postmenopausal women who have had a hysterectomy
The USPSTF recommends against the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal women who have had a hysterectomy”.3

Osteoporosis

How may osteoporosis be prevented?

In Menopause FAQs: Your Health After Menopause – Q. What can I do to prevent osteoporosis? the NAMS elaborate on

“A. …Talk to your healthcare provider about your risk of osteoporosis and what you can do to help keep your bones strong, especially with good nutrition and exercise”.4

Heart Disease

How may heart disease be prevented?

In Menopause FAQs: Your Health After Menopause – Q. Do I have to start worrying about heart disease? the NAMS elaborate on:

“A. You do. Although many women think of heart disease as a man’s disease, the number one killer of women in North America is cardiovascular disease, that is, diseases of the heart and circulatory system. After age 55, more than half of all the deaths in women are caused by cardiovascular disease. Risk for this disease increases after menopause. Be sure to talk to your healthcare team about what your risks are and how you can reduce them”.5

Benefits and Risks

For older women, what is the HT benefit-risk ratio?

On page one in NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use published 20 June 2017, the NAMS explain:

  • “For women who initiate HT more than 10 or 20 years from menopause onset or when aged 60 years or older, the benefit-risk ratio appears less favorable than for younger women because of greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia”.6

On page one in Deciding About Hormone Therapy Use: Potential Risks published in June 2017, the NAMS also elaborate on:

  • “As with all medications, HT is associated with some potential risks. For healthy women aged younger than 60 years with bothersome hot flashes who are within 10 years of menopause, the benefits of HT generally outweigh the risks. Hormone therapy might slightly increase your risk of stroke or blood clots in the legs or lungs (especially if taken in pill form). If started in women aged older than 65 years, HT might increase the risk of dementia. If you have a uterus and take estrogen with progestogen, there is no increased risk of cancer of the uterus. Hormone therapy (combined estrogen and progestogen) might slightly increase your risk of breast cancer if used for more than 4 to 5 years. Using estrogen alone (for women without a uterus) does not increase breast cancer risk at 7 years but may increase risk if used for a longer time”.7

Stop or Not

If I am an older woman, do I need to discontinue HT?

On page one in the NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use published 20 June 2017 the NAMS elaborate on:

  • “Hormone therapy does not need to be routinely discontinued in women aged older than 60 or 65 years and can be considered for continuation beyond age 65 years for persistent hot flashes, quality-of-life issues, or prevention of osteoporosis after appropriate evaluation and counseling of benefits and risks”.8

Health Care Provider

What if I would like to choose to use HT to prevent aging?

If you would like to choose to use HT to prevent aging, it may be in your best interest to also choose to talk to your health care provider about this.

One of the points of consensus about menopausal hormone therapy (MHT) in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

  • “The option of MHT is an individual decision in terms of quality of life and health priorities as well as personal risk factors such as age, time since menopause and the risk of VTE, stroke, ischemic heart disease and breast cancer. MHT should not be recommended without a clear indication for its use”.9

What is VTE?

VTE can be an abbreviation for Venous Thromboembolism.

On page two in the NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use published 20 June 2017 the NAMS’s current president reassures older women and elaborates on:

““…women older than 65 years old will be relieved to know that they don’t have to stop using hormone therapy for their bothersome hot flashes just because of their age. The data simply do not support it, but individualized evaluation and discussion is recommended””.10

Health Topics A-Z

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  1. 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy
  2. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 6. Myth – Complementary Medicines and Therapies Are As Effective As MHT and Safer
  3. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 7. Myth – Compounded Bioidentical Hormone Therapy Is Safer Than Conventional MHT
  4. Bioidentical Hormone Therapy
  5. Bioidentical Hormones Explained – A British Menopause Society Video
  6. Bioidentical Hormones: Are They Safer?
  7. Hormone Therapy and AgingCombined Menopausal Hormone Therapy (MHT)
  8. Complementary Medicine Options for Menopausal Symptoms
  9. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  10. Deciding About Hormone Therapy
  11. Deciding About Hormone Therapy Use
  12. Decidir Sobre La Hormonoterapia
  13. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  14. Estrogen & Hormones: Postmenopausal Hormone Replacement Therapy
  15. Estrogen (Vaginal Route): Before Using
  16. Estrogen (Vaginal Route): Description and Brand Names
  17. HRT
  18. HRT and Breast Cancer: Overall Risks and Benefits Explained – A British Menopause Society Video
  19. HRT and the Risk of Breast Cancer Explained – A British Menopause Society Video
  20. Health After Menopause
  21. Healthy Living By Age
  22. Healthy Living By Age: Healthy Living In Your 40s
  23. Healthy Living By Age: Healthy Living In Your 50s
  24. Healthy Living By Age: Healthy Living In Your 60s
  25. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  26. Hormone Replacement Therapy (HRT): Risks
  27. Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions
  28. Hormone Therapy: Is It Right for You?
  29. Hormones After Age 65 Are OK for Some Women
  30. Index To Drug-Specific Information [United States]
  31. Information About Menopause [Multiply Languages] [Videos]
  32. Menopausal Hormone Therapy: Preventative Medication
  33. Menopause
  34. Menopause
  35. Menopause
  36. Menopause
  37. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  38. Menopause FAQs: Your Health After Menopause
  39. Menopause Hormone Therapy: Who Shouldn’t Take It?
  40. Menopause Treatment
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  42. Menopause and Women’s Health In Later Life
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  44. Menopause – How Will It Affect My Health? [Multiply Languages] [Video]
  45. Menopause – Non-Hormonal Treatment Options [Multiply Languages] [Video]
  46. Menopause: Diagnosis & Treatment
  47. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  48. Menopause: Medicines To Help You
  49. Menopause: Menopause – Hormone Treatments
  50. Menopause: Profiles – Postmenopausal [Video Interview Stories]
  51. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  52. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  53. National Center for Complementary and Integrative Health: Menopausal Symptoms In Depth
  54. National Center for Complementary and Integrative Health: Natural Doesn’t Necessarily Mean Safer, or Better
  55. National Center for Complementary and Integrative Health: Women’s Health and Complementary Approaches
  56. Oestrogen Only Menopausal Hormone Therapy
  57. Revised Global Consensus Statement on Menopausal Hormone Therapy
  58. Video Series-2020 – Bone Health What You Need To Know
  59. Video Series-2020 – How To Talk To Your Primary Care Clinician About Your Overall Health
  60. Video Series-2020 – What You Need To Know About Bioidentical Hormone Therapy
  61. Video Series-2020 – What Women Need To Know About Heart Disease

Sources

Where may I find the Sources quoted?

You may find the Sources at:

Sources

  1. Deciding About Hormone Therapy Use: Potential Risks. 2017:2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 08 October 2020
  2. Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions – Recommendation Summary. 12 December 2017. U.S. Preventative Services Task Force https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/menopausal-hormone-therapy-preventive-medication Accessed: 08 October 2020
  3. Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions – Recommendation Summary. 12 December 2017. U.S. Preventative Services Task Force https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/menopausal-hormone-therapy-preventive-medication Accessed: 08 October 2020
  4. Menopause FAQs: Your Health After Menopause – Q. What can I do to prevent osteoporosis? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-your-health-after-menopause Accessed: 08 October 2020
  5. Menopause FAQs: Your Health After Menopause – Q. Do I have to start worrying about heart disease? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-your-health-after-menopause Accessed: 08 October 2020
  6. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use. 20 June 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/default-document-library/ht-press-release-061917.pdf Accessed: 08 October 2020
  7. Deciding About Hormone Therapy Use: Potential Risks. 2017:2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 08 October 2020
  8. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use. 20 June 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/default-document-library/ht-press-release-061917.pdf Accessed: 08 October 2020
  9. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT. Climacteric, 2016;19:4:314 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 08 October 2020
  10. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use. 20 June 2017:2. North American Menopause Society https://www.menopause.org/docs/default-source/default-document-library/ht-press-release-061917.pdf Accessed: 08 October 2020

Topic Last Updated: 08 October 2020 – Topic Last Reviewed: 08 October 2020
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