Hormone therapy (HT) is a medical treatment that involves the use of hormones, such as estrogen and progesterone, to relieve symptoms associated with menopause.

Menopause is a natural biological process that marks the end of a woman’s menstrual cycles. It is typically diagnosed when a woman has gone without a period for 12 consecutive months. Menopause can cause a variety of symptoms, including hot flashes, night sweats, vaginal dryness, and mood changes.

Hormone therapy can help alleviate these symptoms, but it is not without risks. This article will explore the association between hormone therapy and heart health.

Hormone Therapy and Cardiovascular Disease

Cardiovascular disease (CVD) is a term that refers to a class of disorders that affect the heart and blood vessels. It is the leading cause of death in women worldwide. Several studies have investigated the relationship between hormone therapy and CVD.

The Women’s Health Initiative (WHI) study is one of the most well-known studies on this topic. The WHI study found that women who took estrogen and progestin (a synthetic form of progesterone) had a higher risk of several cardiovascular events, including stroke, blood clots, and heart attacks, compared to women who took a placebo.

However, this risk was highest for women who started hormone therapy at an older age, and who had underlying cardiovascular risk factors, such as high blood pressure and diabetes.

Hormone Therapy and Coronary Heart Disease

Coronary heart disease (CHD) is a type of cardiovascular disease that specifically affects the coronary arteries, which supply blood to the heart. Several studies have explored the relationship between hormone therapy and CHD.

The Nurses’ Health Study (NHS) found that women who took estrogen alone had a lower risk of developing CHD, compared to women who did not take hormone therapy. However, this benefit was only observed in women who started hormone therapy within 10 years of menopause, and who did not have underlying cardiovascular risk factors.

The NHS also found that women who took estrogen and progestin had a higher risk of CHD, and that this risk increased with duration of use.

Factors that Affect the Association Between Hormone Therapy and Heart Health

Several factors can affect the association between hormone therapy and heart health, including age, timing, duration, and type of hormone therapy, as well as underlying cardiovascular risk factors.

Age is an important factor, as the risk of cardiovascular disease increases with age. Women who start hormone therapy at an older age may be at a higher risk of cardiovascular events, compared to women who start at a younger age.

Timing is also important, as the benefits and risks of hormone therapy may vary depending on when it is started relative to menopause. Women who start hormone therapy closer to the onset of menopause may be at lower risk of cardiovascular events, compared to women who start hormone therapy many years after menopause.

The duration of hormone therapy is another important factor to consider. Women who use hormone therapy for a longer duration may be at a higher risk of cardiovascular events, compared to women who use hormone therapy for a shorter duration.

The type of hormone therapy used is also important, as synthetic progestins have been associated with a higher risk of cardiovascular events, compared to natural progesterone. Lastly, underlying cardiovascular risk factors, such as high blood pressure, diabetes, and smoking, can increase the risk of cardiovascular events in women who use hormone therapy.

Conclusion

In conclusion, the association between hormone therapy and heart health is complex and depends on several factors, including age, timing, duration, and type of hormone therapy, as well as underlying cardiovascular risk factors.

Hormone therapy can have both benefits and risks in relation to cardiovascular disease, and the decision to use hormone therapy should be made on an individual basis, after a careful evaluation of the risks and benefits. Women who are considering hormone therapy should discuss their options with a healthcare provider, and should be aware of the potential risks and benefits.