Taking hormone replacement therapy during the perimenopause or early menopause may reduce the risk of heart attacks and stroke. A study of nearly 2800 women over 20 years suggests that starting HRT around this time lowers the risk of serious cardiovascular events. However, much more research is required to understand how the treatment may have this effect and the optimal time to take it.
Everything is perimenopause now – but what if it’s not? A recent study in Spain suggests that nearly 80 per cent of women experience vasomotor symptoms – hot flushes and night sweats – around the menopause. However, other research from this year suggests this varies substantially around the world.
These symptoms can be treated via HRT, which is available in different formulations, such as tablets, patches, gels and sprays. These replace oestrogen and progesterone, hormones that fall as the menopause approaches. The controversy around HRT started in 2002, when a large trial linked it to an increased risk of breast cancer, heart attacks and stroke.
The method of this trial, and subsequent ones, has since been called into question. Newer research has also put the results into context by comparing them with other lifestyle choices, such as alcohol intake. In 2021, a study found that HRT doesn’t increase the risk of early death.
What’s more, earlier studies generally looked at women around the age of 60. This is despite menopause usually occurring between the ages of 45 and 55, and some people taking HRT during the perimenopause. Now, El Khoudary and her colleagues have looked at 2737 participants in the Study of Women’s Health Across the Nation, which was made up of women in the US aged 42 to 52 at enrollment.
All these women experienced hot flushes and night sweats, but only 755 took some form of HRT over the 20-year study period. During this time, 224 fatal and non-fatal cardiovascular events occurred. The researchers estimated that the women who started HRT 10 years or less after the onset of vasomotor symptoms were 27 per cent less likely to experience these events than those who didn’t take HRT.
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