In recent years, hormone therapy (HT) has been a topic of contention among women and healthcare professionals, largely due to concerns raised by a controversial study in the early 2000s associating HT with increased risks of certain cancers and heart disease. While subsequent research has challenged the validity of these findings, apprehension surrounding the use of hormone therapy, especially for women over 65, has persisted.
However, a new study published in Menopause, the journal of The Menopause Society, sheds light on the issue. Conducted by analyzing data from 10 million senior women on Medicare spanning from 2007 to 2020, researchers found that the risks associated with hormone therapy after age 65 varied depending on factors such as dosage and administration method. Consequently, the study concluded that there should be no blanket rule for discontinuing hormone therapy solely based on age, and continuing the treatment beyond age 65 could be beneficial for alleviating menopausal symptoms.
According to experts, hormone therapy remains the most effective treatment for managing severe menopausal symptoms such as hot flashes, night sweats, vaginal dryness, and bone loss. Despite its efficacy, however, it is underutilized, with only a small percentage of women having received prescriptions for HT in 2020.
Hormone therapy, also known as hormone replacement therapy (HRT), involves administering estrogen and, in some cases, progestin to replenish hormones lost during menopause. This treatment has been endorsed by the American College of Obstetricians and Gynecologists (ACOG) as the optimal approach for managing menopausal symptoms.
The controversy surrounding hormone therapy stems largely from the initial findings of the Women’s Health Initiative clinical trial in 2003, which associated a combination of estrogen and progestin with increased risks of various health issues. Subsequent research, however, has discredited these findings, attributing the skewed data to the study’s flawed design.
Recent studies have indicated that while estrogen alone may not pose significant risks, combining it with certain forms of progesterone could potentially increase the risk of breast cancer. Nonetheless, experts emphasize that the benefits of hormone therapy, especially when initiated before the age of 60 or within 10 years of menopause onset, generally outweigh the risks.
Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, considers the latest research reassuring, emphasizing that hormone therapy can offer both short-term and long-term benefits for the majority of women experiencing menopause. Similarly, Dr. Jessica Shepherd, a gynecologist and menopause expert, underscores the importance of these findings for women who may have been advised to discontinue hormone therapy prematurely.
Despite the proven benefits of hormone therapy, many women remain unaware of its potential advantages, highlighting the need for increased awareness and education. Moreover, if healthcare providers are reluctant to prescribe hormone therapy based solely on age, seeking a second opinion from a specialist is advisable.
In summary, the latest research provides valuable insights into the safety and efficacy of hormone therapy for women over 65, challenging previous assumptions and underscoring the importance of individualized healthcare decisions guided by comprehensive medical assessment and informed consent.
