Hormone replacement therapy may be especially dangerous for older women with diabetes, researchers said Monday, but a separate group said HRT may not be so harmful for younger, healthy women.
The two studies are among several that will break down just who is most at risk by studying the details from the giant Women’s Health Initiative, which found that hormone replacement therapy actually raises the risk of heart disease, stroke and some forms of cancer.
Doctors and patients alike have complained that the findings are confusing, and many experts say that HRT can be safe and useful for short-term relief of some of the debilitating symptoms of menopause.
The big study that determined the risk of HRT looked at women well past menopause, with an average age of 63, and looked at a very large population of women with various characteristics.
To narrow it down, Barbara Howard, president of MedStar Research Institute in Washington, and colleagues studied 423 women past menopause who had atherosclerosis, a hardening of the arteries.
“People once thought that hormone therapy could prevent heart disease in women, especially in women with diabetes, who have an increased risk,” Howard said in a statement.
“But this study provides evidence that hormone therapy should not be used to reduce cardiovascular disease risk in women with diabetes or pre-diabetes.”
Less risk for younger women
The women took either estrogen, estrogen plus progestin or a dummy pill for an average of nearly three years.
The women who had abnormal glucose tolerance -- meaning they either had diabetes or pre-diabetes -- and who took hormones had changes in their blood suggesting they had a higher risk of heart disease, Howard’s team reported in the American Heart Association journal Circulation.
But another report published in the June issue of Fertility and Sterility said younger women just entering menopause may not risk heart disease as much when they take HRT.
Dr. Frederick Naftolin of Yale University in Connecticut and colleagues noted that few women in their 40s and early 50s took part in the Women’s Health Initiative.
“The effects of hormone therapy on the health of a woman in her 40s just beginning the menopausal transition will be different from its effects on a woman 15 years older,” said Dr. Marian Damewood, president of the American Society for Reproductive Medicine, which publishes the journal.