Fifteen years after a major study suggested that hormone replacement therapy put menopausal women's health at risk, follow-up research has found that the hormones did not increase premature deaths.
"In clinical decision making, these considerations must be weighed against the impact of untreated menopausal symptoms that women experience, including impaired quality of life, disrupted sleep, reduced work productivity and increased health care expenditures", she added. They were followed for 18 years and tracked for chronic diseases like cancer, as well as heart attack and deaths.
But women who took HRT - where these hormones are prescribed - for two or more years lost an average of 46 ml less of lung volume compared with women who never took HRT.
Overall, nearly 7,500 women died, which was about 27 percent each in the hormone and dummy pill groups. During the follow-up, 7,489 deaths occurred, more than twice as many deaths as were included in earlier reports that had shorter follow-up periods.
"It is a bit surprising that given the many risks of hormone therapy identified during the treatment phase, the net effect on all-cause mortality was neutral", says Manson, who leads one of the WHI's multiple study sites.
Among the youngest women, there were fewer overall deaths early on among hormone users than dummy-pill users, but the rates evened out after women stopped using the pills.
The current study, however, looked at longer-term data from the WHI study and found no increased risk of death from all causes, or from cancer or cardiovascular issues in particular, associated with hormone use.
"Hormones may be appropriate for some women when used short-term to relieve hot flashes and other bothersome menopause symptoms", said Dr Manson, who was also part of the original research. "However, the findings do not provide support for the use of hormone therapy for the prevention of cardiovascular disease or other chronic diseases", Manson said.
Prempro and Premarin are both approved to treat menopause symptoms and to prevent bone-thinning osteoporosis.
Today, there are new formulations of hormone therapies, which include lower doses and novel administration methods, such as skin patches, gels, and sprays. Additional research on the long-term benefits and risks of these newer treatments is needed, the researchers say.