Hormone Replacement Therapy: Younger Women Benefit

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Hot flashes, insomnia, dry mucous membranes, mood swings - menopause is no picnic for many women. Missing hormones are behind the complaints. However, the health risks of hormone replacement therapy could be much lower than previously assumed.

It makes sense to counter menopausal symptoms by imitating nature and replacing the missing hormones. After all, this works very well with diabetes with insulin or with hypothyroidism with thyroid hormones. But since the publication of the so-called WHI study (Women's Health Initiative) in 2002, hormone replacement therapy has been demonized in menopause. The alleged result of the investigation: the hormones increase the risk of cardiovascular disease, thrombosis, diabetes and even breast cancer.

Years of misinterpretation

Now the study authors spoke up: "The results have been misinterpreted for years," said JoAnn E. Manson and Andrew M Kaunitz. The problem: The study did not want to clarify the general risks of hormone replacement therapy, but rather to answer a completely different question: Do estrogens also have a positive effect on cardiovascular health in women who have long since passed the menopause?

The participants in the WHI study were therefore on average 63 years old. In addition, every second test person had risk factors such as obesity or high blood pressure or previous illnesses such as diabetes or coronary heart disease.

Start at the onset of menopause

If you only look at the younger participants in the study, between 50 and 59 years of age, the result would be very different, says Manson. The risk of diabetes or breast cancer did not increase in these women. On the contrary, even a slight decrease in the breast cancer rate was observed for estrogen therapy alone. However, the proportion of under-60s in the study was low.

"At least a third of menopausal women are so affected by the loss of hormone production that they need medical assistance," says Dr. Christian Albring, President of the Professional Association of Gynecologists."These women no longer need to fear for their health if the doctor recommends hormone replacement therapy." Although the treatment is still controversial in professional circles, Manson is of the conviction: "For younger women, the benefits outweigh the benefits." Ideally, it should Start therapy right at the onset of menopause. (away)

Source: Manson J. E. and Kaunitz A. M. et al .: Menopause management - getting clinical care back on track, The New England Journal of Medicine, 2016.

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