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Study Confirms No HRT Benefit for Older Women

New evidence confirms that hormone replacement therapy (HRT) should not be prescribed to older women who are many years past menopause to help prevent chronic conditions such as heart disease .

But the authors support the view that HRT is a safe short term treatment for younger women in early menopause to relieve symptoms and improve quality of life.

In 2002, the Womens Health Initiative (WHI) trial found that postmenopausal women taking HRT had more heart attacks and strokes than non-HRT users. The trial was halted early and millions of women around the world stopped taking HRT. But scientists now believe that these risks may only apply to older women who do not normally use HRT.

In 1999, another trial (WISDOM) began to assess the long-term risks and benefits of HRT after the menopause. This trial was also stopped after the first WHI results appeared, but the WISDOM findings, published today, make an important contribution to the body of knowledge about HRT when it is initiated in older postmenopausal women.

The WISDOM team identified 5,692 healthy women registered at general practices in the UK, Australia and New Zealand with an average age of 63 years and 15 years after the menopause.

The women who had not had a hysterectomy were split at random into two groups. One was given a daily dose of combined hormone therapy (oestrogen and progestogen) and the other group was given a placebo pill. Women who had had a hysterectomy were split between combined hormone treatment, oestrogen only and a placebo.

All women were monitored for an average of 12 months and main outcomes such as cardiovascular disease, osteoporotic fractures, breast cancer and deaths, were recorded.

There was a significant increase in the number of major cardiovascular events (angina, heart attack or sudden coronary death) and blood clots (venous thromboembolisms) in the combined hormone therapy group compar
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