Hormone replacement therapy has harmed the heart.

When women enter menopause, their ovaries stop producing sex hormones. To "replace" this organ and alleviate menopausal symptoms, hormone replacement therapy is used. However, recent studies suggest that such treatment may increase the risk of breast cancer, while cold exposure can help manage unpleasant feelings during menopause.

Researchers from Uppsala University in Sweden and the University of New South Wales in Australia found that certain hormone replacement therapy medications could increase the risk of cardiovascular diseases, thrombosis, and stroke. The study results were published in the British Medical Journal.

The conclusions of the publication are based on data from 138 studies involving 919,614 healthy women aged 50-58 in Sweden from 2007 to 2020. None of the participants had used hormone replacement therapy for two years prior to the study.

Women from the sample, apart from the control group, were prescribed various hormone replacement therapy medications. Depending on the prescriptions, the study participants were divided into groups:

— continuous oral combined (containing both estrogen and progestogen) hormone therapy,

— oral combined hormone therapy for a fixed period,

— oral estrogens without contraception,

— oral estrogens with local progestogen,

— tibolone,

— transdermal combined hormone therapy,

— transdermal estrogens without contraception.

Subsequently, the scientists monitored the health of the participants for two years, particularly tracking cases of cardiovascular diseases. Socio-demographic factors that could influence the study results were also considered: age, education level, region of residence, high blood pressure, and the presence or absence of diabetes.

A total of 24,089 cases of heart and vascular issues were recorded among the 919,614 women. The risk of ischemic disease was increased by continuous oral combined therapy and tibolone in tablet form. Transdermal procedures—such as the use of special patches, gels, and creams—were associated with a higher likelihood of any cardiovascular diseases.

"If 1,000 women began each of these treatment methods and were observed for a year, we would expect to see seven new cases of venous thromboembolism across all groups," the researchers explained.

An increased risk of thrombosis was observed with oral combined therapy (both continuous and time-limited), oral estrogens without contraception, and transdermal combined therapy. Tibolone did not lead to thrombosis but was associated with an increased risk of stroke and heart attack.

"The results highlight that different combinations of hormones and methods of administration have varying impacts on the risk of cardiovascular diseases," the authors of the article concluded.