A Shift in Thinking on HRT

For the last few years hormone replacement treatment (HRT) has been a ‘bad actor’. Not only had it been shown to fail in preventing cardiovascular disease and Alzheimer’s, but it also was found to promote some cancers and cardiovascular disease. But the needs of menopausal women coupled with the failure of many alternative treatments like black kohosh and soy supplements has caused researchers to think again.

The continued use of HRT for severe menopausal symptoms has received cautious acceptance by many specialists, provided the lowest effective doses are given for the shortest possible time - in such cases, the chances of promoting cancer are almost non-existent. Now there’s a report that the use of estrogen-alone (i.e. unopposed by combination with progesterone) in menopausal women without a uterus doesn’t protect against heart attack or coronary death; however, there’s a suggestion that it may reduce the occurrence of coronary heart disease in women 50 to 59.

These results come from the other half of the huge study that helped damn HRT in the first place, in 2002. They receive some support from a recent report that there may be a ‘window of opportunity’ for finding benefits of HRT in reducing heart attacks when given soon after the start of menopause.