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June 18, 2019  
UTERINE NEWS: Feature Story

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  • Timing May Be the Key to Hormone Therapy

    A Tale of Two Outcomes: Timing May Be the Key to Hormone Therapy

    March 26, 2008

    By: Danae Roumis for Uterus1

    Research presented at an annual meeting of the American Heart Association (AHA) posed findings about hormone therapy that highlight timing as the key to their effect. Studies suggest that hormone replacement therapy (HRT) offers protection against coronary heart disease when started before the age of 45, while putting those who started later in the course of menopause at greater risk for disease. The findings come from the Women's Ischemia Syndrome Evaluation (WISE) study, which was sponsored by the U.S. National Heart, Lung, and Blood Institute (NHLBI).

    Take Action
    Ways to reduce your risk for heart disease:
  • Know and take care of your blood pressure.
  • Exercise regularly.
  • Abstain from smoking.
  • Maintain a healthy weight and eat a balanced diet.
  • Get tested for diabetes and take appropriate precautions if you are diabetic.
  • Be aware of cholesterol and triglyceride levels, and keep them under control.

  • In the United States, heart disease is the leading cause of death and the number-one killer of women, responsible for the death of about 1 in 6 women annually, according to the American Heart Association. Much research has focused on the beneficial effects of hormone replacement therapy in terms of heart health, however the present study offers some caveats. Dr. Nieca Goldberg, AHA spokeswoman and medical director of the Women’s Heart Program at New York University School of Medicine, said that “Women need to be assessed for hormone therapy by their menopausal symptom status and age and whether or not they have heart disease… Hormone therapy should not be used for prevention or treatment of cardiovascular disease, but it should be used in appropriate women who are having menopausal symptoms.” In other words, HRT should be used to treat menopausal symptoms, and may work to prevent heart disease that is associated with menopause, rather than as a first-line treatment in and of itself.

    In 2002, the Women’s Health Initiative (WHI) found that HRT might cause more disease than it prevents. The WISE study provides more information about the element of time with respect to the activities of hormone therapy, and according to its findings, presents evidence for the “window of opportunity” idea, regarding the appropriate age and menopausal conditions for which a woman should be undergoing hormone replacement therapy.

    Related studies proposed that oral contraceptives, as another form of hormone therapy, may confer a heightened risk of plaque development in the arteries, and of cervical cancer, if taken for more than 10 years. Oral contraceptives are used by approximately 100 million women worldwide, and although they have been observationally regarded as a way for women to protect themselves from the adverse health effects of menopause, current research suggests that the “benefits” of the pill might actually be more aligned with the lifestyle factors of those who are taking them (e.g. diet, exercise, quality of healthcare). Dr. Goldberg commented that this presents an opportunity to assess a woman’s risk of cardiovascular disease at an earlier age, since women considering taking the pill would need to consult their doctors about their risks.

    These studies also showed that any benefits of hormone replacement therapy were essentially eliminated in women who smoked regularly. This highlights the importance of maintaining a healthy lifestyle, with or without adding preventative therapies and medications. Heart disease is a serious issue in the United States, and awareness is the most powerful tool to fight it – make sure you speak with your doctor about your risks and about your options for prevention.

    Last updated: 26-Mar-08


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