Research presented at the 2024 Annual Meeting of The Menopause Society in Chicago focused on uncovering the impact of hormone replacement therapy (HRT) on various aspects of health. Some studies found that prolonged use of certain hormone therapies can improve markers of cardiovascular health at menopause. Another large meta-analysis concluded that HRT can enhance insulin sensitivity by restoring estrogen levels, which tend to decrease with age and are responsible for many menopausal symptoms. Debates regarding the safety and consequences of long-term HRT use continue, prompting further research to fill in the knowledge gaps.
A study conducted by researchers from Penn State Hershey Medical Center utilized data from the Women’s Health Initiative to compare cardiovascular health biomarker values in participants taking estrogen-based hormone therapies versus a placebo. The results showed significant improvements in markers of cardiovascular health for those taking conjugated equine estrogens, including increases in “good” cholesterol (HDL-C) and reductions in “bad” cholesterol (LDL-C) and Lipoprotein(a). Markers of insulin resistance were also lower in participants taking HRT, indicating potential benefits for heart health and overall well-being.
Menopausal women experience hormonal changes that increase their risk of heart disease and cardiovascular issues. When estrogen levels decrease, various negative effects on the cardiovascular system may emerge, such as artery plaque buildup, increased cholesterol, and elevated blood pressure. Estrogen plays a crucial role in maintaining blood vessel elasticity and regulating cholesterol levels, highlighting its importance for cardiovascular health. Supplementation with estrogen replacement therapy can help mitigate these risks and support heart health during menopause.
Another study presented at the meeting suggested that HRT was associated with lower insulin resistance in postmenopausal women. A review and meta-analysis of 17 randomized controlled trials involving 29,287 participants found that all HRT studies were linked to improved insulin sensitivity at postmenopause. Given that insulin resistance is a significant risk factor for diabetes, these findings are encouraging and demonstrate the potential metabolic benefits of hormone replacement therapy.
Despite the positive aspects of HRT, it is essential to consider individual differences and potential side effects when prescribing these therapies. Oral HRT preparations may carry a higher risk of increasing platelet aggregation and clotting in blood vessels compared to transdermal or bio-identical hormone replacement therapy. Tailoring the type and dosage of HRT to address specific symptoms and concerns is crucial for optimal treatment outcomes and minimizing risks associated with therapy.
While HRT can be beneficial for managing menopausal symptoms and reducing the risk of osteoporosis, certain individuals with specific health conditions or genetic predispositions may not be suitable candidates for hormone replacement therapy. Consultation with a healthcare provider is vital to assess the individual’s situation and determine the most appropriate treatment approach. Questions surrounding the long-term health impact of HRT, such as its role in breast cancer risk, heart health support, brain health, and the safety of different HRT forms, underscore the need for ongoing research and personalized medical advice to make informed decisions about hormone replacement therapy.
