Hormone Therapy, Heart Disease and Stroke

“Some studies suggest that HT might be good for your heart if you start before age 60 or within 10 years of menopause. However, if you start HT further from menopause…”.¹

Umbrella
What may the Hormone Therapy, Heart Disease and Stroke Umbrella include?

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

Cardiovascular Disease
Coronary Heart Disease
Heart Disease
Hormone Replacement Therapy (HRT)
Hormone Therapy (HT)
Ischemic Heart Disease
Menopausal Hormone Therapy (MHT)
Stroke

Cardiovascular Diseases

What are cardiovascular diseases (CVDs)?

DotS the definition of CVDs may vary. The World Health Organization’s definition is:

“CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. More than four out of five CVD deaths are due to heart attacks and strokes, and one third of these deaths occur prematurely in people under 70 years of age”.²

Type

What can it be important to be clear about with hormone therapy (HT), heart disease and stroke information?

It can be important to be clear about the type of HT – Estrogen Plus Progestogen HT or Estrogen Therapy.

Younger Than Age 60 or Not

What can it also be important to be clear about with HT, heart disease and stroke information?

It can also be important to be clear about whether HT, heart disease and stroke information is about women “younger than age 60 years or within 10 years of menopause”.

Younger Than Age 60

For women younger than age 60 or within 10 years of menopause, what is the association between HT and heart disease and stroke?

On page one in Deciding About Hormone Therapy: Potential Risks, published July 2022, the North American Menopause Society (NAMS) explain:

“As with all medications, HT is associated with some potential risks. For healthy women with bothersome hot flashes aged younger than 60 years or 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)”.³

After Age 60

For women after age 60 or further than 10 years from menopause, what is the association between HT, heart disease and stroke?

On page one in Deciding About Hormone Therapy: Potential Risks, the NAMS also note:

“Some studies suggest that HT might be good for your heart if you start before age 60 or within 10 years of menopause. However, if you start HT further from menopause or after age 60, HT might slightly increase your risk of heart disease. Although there are risks associated with taking HT, they are not common, and most go away after you stop treatment”.⁴

U.S. Preventative Services Task Force

In 2022, what did the (United States) U.S. Preventative Services Task Force (USPSTF) note in their final recommendations about the use of HT for the primary prevention of chronic conditions in postmenopausal persons?

In Hormone Therapy In Postmenopausal Persons: Primary Prevention of Chronic Conditions, published 01 November 2022, the USPSTF’s recommendations include:

Hormone Therapy, Heart Disease and Stroke

“Postmenopausal persons
The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal persons”.⁵

In Hormone Therapy In Postmenopausal Persons: Primary Prevention of Chronic Conditions, published 01 November 2022, the USPSTF’s recommendations also include:

“Postmenopausal persons who have had a hysterectomy
The USPSTF recommends against the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal persons who have had a hysterectomy”.⁶

Health Care Provider

What if I choose to use HT and would like to lower my risk of heart disease and/or stroke?

If you would like to choose to use HT and lower your risk of heart disease and/or stroke, it may be in your best interest to also choose to talk to your health care provider about this. Together you can discuss your options and if required, agree on who may be the most appropriate health care provider to help you.

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