Menopause

What are the risks of hormone therapy beyond age 65?

April 22, 2024

Among senior Medicare women, the implications of menopausal hormone therapy (HT) use beyond age 65 years vary by types, routes, and strengths. In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with estradiol (E2) rather than conjugated estrogen.

• Investigators used prescription drug and encounter records of 10 million senior Medicare women from 2007-2020.
• Compared with never use or discontinuation of menopausal HT after age 65, the use of estrogen monotherapy beyond age 65 years was associated with significant risk reductions in mortality (19%), breast cancer (16%), lung cancer (13%), colorectal cancer (12%), congestive heart failure (CHF) (5%), VTE (3%), atrial fibrillation (4%), acute MI (11%), and dementia (2%).
• For combo-therapy, both E+ progestin and E+ progesterone were associated with increased risk of breast cancer by 10% to 19%, but such risk can be mitigated by using low dose of transdermal or vaginal E+ progestin.
• Moreover, E+ progestin exhibited significant risk reductions in endometrial cancer (45%), ovarian cancer (21%), ischemic heart disease (5%), CHF (5%), and VTE (5%), whereas E+ progesterone exhibited risk reduction only in CHF (4%).

Source:

Baik SH, et al. (2024, April 9). Menopause. Use of menopausal hormone therapy beyond age 65 years and its effects on women's health outcomes by types, routes, and doses. https://pubmed.ncbi.nlm.nih.gov/38595196/