Menopause treatment pills may impact heart health: here’s what study says

Hormone pills taken during menopause relieve symptoms, but do they pose long-term health risks? Scientists have found that hormone replacement therapy (HRT), pills containing both estrogen and progestin, may increase the risk of heart disease and blood clots in menopausal women.

During menopause, a woman’s body undergoes a number of changes caused by a decrease in the level of female hormones, progesterone and estrogen, which causes symptoms such as hot flashes, mood swings, night sweats, insomnia and vaginal dryness. These symptoms are often frustrating and interfere with daily life and mental well-being.

HRT was once commonly prescribed to relieve the symptoms of menopause and reduce the risk of bone loss at this stage. However, recent research indicating long-term risks has led to a more cautious approach. It is currently only recommended for those where the benefits outweigh the risks. The estimate shows that only 5% of U.S. women currently use it, a significant drop from about 27% two decades ago.

Latest test published in The BMJ examined the effects of HRT pills on heart health based on the route of administration and the combination of hormones used. The study suggests that pills containing both estrogen and progesterone, such as oral continuous combination therapy, oral combined sequential estrogen therapy without contraindications, and combined transdermal therapy, increase the risk of coronary heart disease and venous thromboembolism (blood clots) in women.

The researchers also found that tibolone tablets in particular were linked to a higher risk of heart disease, heart attack and stroke, but not to a higher risk of blood clots. Tibolone is a synthetic hormone containing estrogen, progesterone and testosterone.

“Compared with not initiating menopausal hormone therapy, initiating continuous oral combination therapy or tibolone was associated with an increased risk of coronary heart disease,” the press release stated.

“If 1,000 women started each of these therapies and were followed for a year, we would expect to see seven new cases of venous thromboembolism across all groups,” the researchers wrote.

However, there has been no increased risk associated with transdermal treatments such as patches, gels and creams.

The researchers caution that the study does not prove that HRT causes a risk to heart health because the findings are based on observational data. Results may also have been influenced by lack of information on menopausal status and other unmeasured factors such as smoking and body mass index.