A recent study conducted by the Women’s Health Initiative found that hormone replacement therapy, calcium and vitamin D supplementation, and a low-fat diet may not be as effective as previously believed in preventing certain diseases in postmenopausal women. The study, published in JAMA, evaluated the long-term effects of these treatments on the health of over 161,000 women aged 50 to 79 over a period of up to 20 years. Although these treatments have been commonly used to prevent cardiovascular disease, fractures, and cancer in menopausal women, the researchers found that they could not support their use as preventive measures for some diseases.
The study found that hormone replacement therapy did not reduce the risk of cardiovascular diseases, including heart disease, stroke, dementia, and other chronic conditions, in postmenopausal women. Furthermore, the therapy was associated with an increased risk of breast cancer. However, the researchers noted that hormone therapy did help alleviate vasomotor symptoms such as hot flashes and night sweats in women. Dr. Nicole Weinberg, a cardiologist at Providence Saint John’s Health Center, emphasized the importance of treating menopausal symptoms symptomatically while acknowledging the limitations of hormone therapy for preventing cardiovascular disease.
Similarly, calcium and vitamin D supplementation did not prevent fractures in postmenopausal women, according to the study. The participants in the study received 1,000 mg of calcium and 400 IU of vitamin D per day, but supplementation did not decrease the incidence of hip fractures. While the researchers suggested that women who do not meet dietary guidelines might benefit from supplements, additional research indicated that supplementation could potentially increase the risk of death from cardiovascular disease.
The study also examined the efficacy of a low-fat diet with increased fruits, vegetables, and grains in preventing breast or colorectal cancer in postmenopausal women. While the diet did not significantly reduce the incidence of these cancers, a long-term follow-up did note a reduction in breast cancer mortality. Dr. Adi Katz, the director of gynecology at Northwell Lenox Hill Hospital, highlighted the importance of providing support to women during perimenopause, a transitional period characterized by hormonal fluctuations that may impact mental health.
The researchers noted several limitations to the study, including the use of the most common hormone therapy treatment, potential effects of non-study calcium and vitamin D supplements, and the inability to distinguish the effects of reducing fat from the impact of increasing fruits, vegetables, and grains in the low-fat diet. Overall, the findings suggest that while hormone replacement therapy, calcium and vitamin D supplementation, and a low-fat diet may not be highly effective in preventing certain diseases in postmenopausal women, symptom relief and support during menopause remain important considerations for healthcare providers.
