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Latest ‘news’ about hormone replacement therapy (HRT) and the heart

It would be true to say that for every study that claims benefits for hormone replacement therapy (HRT), there is another that says it isn’t beneficial. There are host of reasons why this might be the case and this is not really the place to have this debate – suffice it to say that the latest information from the 49th Annual Meeting of the American College of Cardiology, which was presented in March this year has stated that the claims that HRT can be beneficial to the heart may have been overstated.

A new study called ERA (Estrogen Replacement and Atheriosclerosis trial) has claimed to show that HRT does not prevent heart disease in older women.  However, the study was with 309 older women who were on average 65 years old and who ALREADY had heart disease.  They were each randomly given Premarin (an oestrogen only preparation), Prempro (an oestrogen and progesterone combination) or a placebo.

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As the study progressed, the researchers used quantitative coronary angiography to identify and measure any changes to the participants arteries that occurred as a result of treatment. The changes that researchers were looking for included, further narrowing of the arteries and a build up of cholesterol, both of which can lead to chest pain and heart attack.

The group were followed up, on average, after 3.2 years and (perhaps unsurprisingly as all the women already had heart disease) all three groups showed the same rate of narrowing of the coronary vessels. The researchers have concluded that neither oestrogen alone nor oestrogen combined with a progesterone had positively changed the course of the existing heart disease compared to those women who had been given the placebo.

Now, I’m not one to carp on about this – but surely if you wanted to check whether heart disease was prevented by the use of hormone replacement therapy then you should perhaps have been considering working with women who didn’t display heart disease to start with!

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Linda Parkinson-Hardman

Transformational coach and founder of the Hysterectomy Association. Professionally I'm an information scientist who specialises in the adoption and engagement of digital technologies. I am a writer and author of nine books to date, and I've edited a further seven; phew what a lot for a Thursday afternoon :-)

This Post Has 11 Comments
  1. I had a total hysterectomy 23 years ago and was put on Hormonin straight away. For 20 years I was fitter than any woman half my age. I never had cause to go to my doctor except for repeat prescriptions of hrt. Then along comes a new doctor about 12 years old who insisted I stop taking hrt as I was on it for long enough. In the last three years I have felt myself go gradually down hill. I can’t sleep no energy aching joints lack of interest in anything libido is none existent, need I go on. I am also sole carer for my disabled daughter and due to the latter symptoms, her life is affected too as I just don’t have the energy to take her out or do any of the things we used to. The hot flushes are not only embarrassing but very unpleasant. Why do gp’s think they have the right to dictate what is good for women who know their own bodies better than anyone. Surely the fact that for more than twenty years whilst taking hrt and never visiting my doctor for any health issues speaks for itself. Heaven knows how many years of life I have ahead of me but if this is how I have to spend the rest of my days then long live hrt I say and doctors you should listen to your patients and not be so tunnel visioned about age versus hrt especially those narrow minded male doctors who will never know the difficulties of menopause, or teenage female doctors who have yet to grow up and experience menopause themselves I wonder if when their time comes will they be so willing to dismiss the benefits of hrt or does the prospect of menopause not enter their psych .

  2. Leeann, I had a total hysterectomy 28 years ago. I was put on Hormones immediatly. Premarin, I went off of that med because of the way it is harvested. It is from horses which they keep peregnent, it is their urine. I feel this is cruel, where do all the colts, babys go? I went on estrace which is a synthetic. I never had a hot flash, I always felt fine when taking the hormone. I was recently taken off because I had a heart attack and was told hormones could be one of the causes. I now at my old age have hot flashes, it is bothersome. I would like to go back on the med, just a small amount to curb that problem. I feel the studies have been on and off on this medication and I can’t understand why they can’t be more accurate on their diagnosis. I hope you feel better soon, you should be by now. They say 6-8 weeks you can drive and do the normal tasks, and I did listen to the doctor.

  3. hello i had hysterectomy done 7 weeks ago and was ut on hrt patches yesterday and iron tablels. my overaies have given up was told i will be on both for along time. feel so weak, worn out and feel loke im going to be sick had the worst night ever last night. can any one tell how long before i feel my self again . im 38 and feeling very lost as it has all been a bit o a shock 🙁 leeann

  4. I am 70, and nearly 10 years off estrogen. Due to uterine prolapse, must have hysterectomy and possibly have the ovaries and tubes removed as well.
    Since I went off estrogen (due to the study scare) it as though I practically watch my body sag and die. I would like to go back on estrogen to prevent any further damage being. Have bad arthritis but no sign osteoporosis so far. Would also like to participate in a GOOD, RELIABLE study based on genuine random sampling.
    Any info on women my age? Opinions appreciated. Thanks.

  5. There is conflicting advice about HRT Ann and it is worth that most research and advice is given for women going through the menopause normally. For women going through the menopause surgically after having had a hysterectomy the suggestion is often made by medical professionals that you take it until you are 50 as you are simply replacing what you would have produced yourself. You then need to make a decision about whether you continue after the age of 50.

  6. hi linda thanks for replying yes but im just so confused the doctors wont tell me much about it but i was told you should not be on hrt longer than 10 years and if there is a histoty of cancer in the family but if i dont take them i can get brittle bone so im really not sure what to do i could do with finding some were i can go and talk it over with them but iv not long moved to kidderminster so dont know were to start .

  7. hi i had a hysterectomy when i was 26 im now 42 i have been on hrt all that time but been having a lot of headaks so stoped taking them and the doctors did a blood test but my levels were 2 low so they want me 2 go back on them so im just trying to find out more my doctors dont tell me need 2 know the best way to go about this thankyou.

  8. Thanks Jules – I find there is often another ‘side to the story’ with all research 🙂

  9. Thankyou for this. I am totally in agreement with you that some studies, such as this one. are done using the wrong group of women. All the women I have chatted to on this site are well under 65 and, as far as I know, do not have heart problems. As you say, it should be a study on the preventative effects of HRT not a study on reducing heart disease. It is confusing enough deciding whether or not to take it without these so called “experts” adding to the confusion and worry.
    I am considering taking it until I am 50 and then going for alternative methods

    prune tune Jules (TAH/BSO 15th Sept 2011)

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