Hormone Therapy Reduces Menopausal Symptoms in Women in their 60s, Risky After 70

A recent secondary analysis of two major randomized clinical trials has assessed the effectiveness of menopausal hormone therapy (HT) for managing vasomotor symptoms (VMS) in postmenopausal women. The study included 27,347 women aged 50 to 79 years, evaluating the impact of conjugated equine estrogens (CEE), alone or combined with medroxyprogesterone acetate (MPA), on cardiovascular health.

Results indicated that both CEE alone and CEE plus MPA effectively reduced moderate to severe VMS in women aged 50 to 59 years, without elevating the risk of atherosclerotic cardiovascular disease (ASCVD). While women aged 60 to 69 showed a slightly higher but not clearly harmful cardiovascular risk, those 70 years and older experienced significantly increased ASCVD events with both therapies.

The findings reinforce current guidelines recommending HT for symptom relief in younger postmenopausal women, suggest caution for women in their 60s, and advise against initiating therapy in women 70 years and older due to elevated cardiovascular risks.

Reference:

Rossouw JE, Aragaki AK, Manson JE, Szmuilowicz ED, Harrington LB, Johnson KC, Allison M, Haring B, Saquib N, Shadyab AH, Rexrode KM, Liu L, Mouton CP, LaCroix AZ. Menopausal Hormone Therapy and Cardiovascular Diseases in Women With Vasomotor Symptoms: A Secondary Analysis of the Women's Health Initiative Randomized Clinical Trials. JAMA Intern Med. 2025 Sep 15:e254510. doi: 10.1001/jamainternmed.2025.4510. Epub ahead of print. PMID: 40952729; PMCID: PMC12439186.

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2838720