HRT Neither Raises Nor Lowers Risk of Dying

By Sondra Forsyth

Menopausal hormone therapy (HT) does not have a significant effect on the risk of death, according to a Mayo Clinic review of the medical literature published over the past three decades. The results, which included studies with follow-up as long as 18 years, were presented in March 2015 at the Endocrine Society’s 97th annual meeting in San Diego.

A release from the society quotes lead investigator Khalid Benkhadra, MD, as saying, “At present, we do not have evidence that hormone therapy in postmenopausal women increases mortality or protects from death compared with women who never used hormones.”

The results, Benkhadra said, should allay concerns of some women with debilitating menopausal symptoms who have feared taking hormones.

The release notes that Benkhadra and colleagues reached their conclusion after comprehensively searching several large databases of published medical literature from their earliest inception (1982 and later) through August 2013.

They conducted a systematic review and meta-analysis, or quantitative statistical analysis, of the medical literature using only studies of moderate to high-quality scientific evidence. The researchers included clinical trials of postmenopausal women in the analysis only if the studies lasted longer than six months, randomized patients to receive HT or either placebo (sham treatment) or no treatment. Women were age 50 or older in the 43 studies included in the analysis.

The investigators found no statistically significant relationship between HT use and all-cause mortality–death due to any reason–or death due to heart attack, breast cancer or stroke. There also was no significant association between HT use and death when they performed a subgroup analysis based on hormone type, estrogen alone or estrone plus progesterone, according to Benkhadra.

Benkhadra said their research could be used to clarify the indications for taking HT.