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

2017 Recommendations

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

2021 Recommendations

Are the USPSTF currently updating Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions?

In Menopausal Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions, last updated 11 February 2021, the USPSTF, note:

“An Update for This Topic is In Progress”.4

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”.5

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”.6

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:

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 younger women because of greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia”.7

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”.8

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”.9

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”.10

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””.11

Health Topics A-Z

Where may I find Health Topics related to Hormone Therapy and Aging?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

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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. Archives: Videos – Managing Menopause In Women With Chronic Medical Conditions
  5. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women
  6. Bioidentical Hormone Therapy
  7. Bioidentical Hormones Explained – A British Menopause Society Video
  8. Bioidentical Hormones: Are They Safer?
  9. Hormone Therapy and AgingCombined Menopausal Hormone Therapy (MHT)
  10. Complementary Medicine Options for Menopausal Symptoms
  11. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  12. Compounded Bioidentical Hormone Therapy [Video]
  13. Consumer Health: Menopause, Hormone Replacement Therapy and Heart Health
  14. Deciding About Hormone Therapy
  15. Deciding About Hormone Therapy Use
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  17. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  18. Estrogen & Hormones: Postmenopausal Hormone Replacement Therapy
  19. Estrogen (Vaginal Route): Before Using
  20. Estrogen (Vaginal Route): Description and Brand Names
  21. Experiencing Vaginal Dryness? Here’s What You Need To Know
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  23. HRT and Breast Cancer: Overall Risks and Benefits Explained – A British Menopause Society Video
  24. HRT and the Risk of Breast Cancer Explained – A British Menopause Society Video
  25. HRT: Benefits and Risks
  26. Health After Menopause
  27. Healthy Living By Age
  28. Healthy Living By Age: Healthy Living In Your 40s
  29. Healthy Living By Age: Healthy Living In Your 50s
  30. Healthy Living By Age: Healthy Living In Your 60s
  31. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  32. Hormone Replacement Therapy (HRT): Risks
  33. Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions
  34. Hormone Therapy for Menopause
  35. Hormone Therapy: Is It Right for You?
  36. How do I deal with vaginal atrophy? — Ask Dr Jean
  37. Information About Menopause [Multiply Languages] [Videos]
  38. International Society for the Study of Women’s Sexual Health: Find A Provider
  39. May Is National Osteoporosis Month [United States]May Is National Osteoporosis Month
  40. Mayo Clinic Minute: What Is Heart Disease?
  41. Mayo Clinic Q&A Podcast: Don’t Miss A Beat With Preventive Heart Care
  42. Menopausal Hormone Therapy: Preventative Medication
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  47. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  48. Menopause FAQs: Your Health After Menopause
  49. Menopause Hormone Therapy: Follow-Up Appointments?
  50. Menopause Hormone Therapy: Who Shouldn’t Take It?
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  52. Menopause – How Will It Affect My Health? [Multiply Languages] [Video]
  53. Menopause – Non-Hormonal Treatment Options [Multiply Languages] [Video]
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  55. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
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  57. Menopause: Menopause – Hormone Treatments
  58. Menopause: Profiles – Postmenopausal [Video Interview Stories]
  59. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  60. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  61. National Center for Complementary and Integrative Health: Menopausal Symptoms In Depth
  62. National Center for Complementary and Integrative Health: Natural Doesn’t Necessarily Mean Safer, or Better
  63. National Center for Complementary and Integrative Health: Women’s Health and Complementary Approaches
  64. Oestrogen Only Menopausal Hormone Therapy
  65. Osteoporosis Explained – A British Menopause Society Video
  66. Patty Brisben Foundation for Women’s Sexual Health: Guide To Sexual Health Providers
  67. Revised Global Consensus Statement on Menopausal Hormone Therapy
  68. Risks and Benefits of MHT
  69. The 2020 Genitourinary Syndrome of Menopause Position Statement of The North American Menopause Society
  70. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data
  71. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  72. Video Series-2020 – Bone Health What You Need To Know
  73. Video Series-2020 – How To Talk To Your Primary Care Clinician About Your Overall Health
  74. Video Series-2020 – What Women Need To Know About Heart Disease
  75. Video Series-2020 – What You Need To Know About Bioidentical Hormone Therapy
  76. Video Series-2021 – Common Issues Surrounding Sexuality and Menopause
  77. Video Series-2021 – Treatment Options for Vaginal Dryness and Urinary Issues
  78. Video Series-2021 – What Women Need To Know About Hormone Therapies
  79. Webinars: Symposia – 2021 Vision: Practical Steps To Optimize Your Benefit-Risk. Discussions for A New Decade

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: 28 April 2021
  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: 28 April 2021
  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: 28 April 2021
  4. Menopausal Hormone Therapy In Postmenopausal Women: Primary Prevention of Chronic Conditions. Last Updated: 11 February 2021. U.S. Preventative Services Task Force https://www.uspreventiveservicestaskforce.org/uspstf/draft-update-summary/menopausal-hormone-therapy-postmenopausal-persons-primary-prevention-chronic-conditions Accessed: 28 April 2021
  5. 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: 28 April 2021
  6. 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: 28 April 2021
  7. 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: 28 April 2021
  8. 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: 28 April 2021
  9. 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: 28 April 2021
  10. 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/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 28 April 2021
  11. 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: 28 April 2021

Topic Last Updated: 28 April 2021 – Topic Last Reviewed: 28 April 2021
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