New clinical and observational research highlights both the significant benefits and potential risks of treatments for menopause symptoms. A 20-year SWAN study reveals that initiating hormone therapy during perimenopause or early postmenopause is associated with a 22% reduction in cardiovascular disease events, particularly benefiting Black women and those starting within 10 years of menopause onset. Additionally, an NYU Grossman study shows hormone therapy significantly improves severe mood symptoms. However, researchers caution that these observational findings should not guide clinical practice, while separate experts warn of inconsistent nutrients and potential toxicity in the rapidly growing menopause supplement market.
Hormone therapy cardiovascular benefits
- ▪A study analyzing 20 years of data from the Study of Women's Health Across the Nation (SWAN) found that initiating hormone therapy during peri- or early postmenopause was associated with a 22% reduced risk of cardiovascular disease events compared to non-use
- ▪The protective cardiovascular effect of hormone therapy was strongest among Black women, who showed an estimated 49% lower risk of cardiovascular events compared to non-users
- ▪The SWAN study researchers noted that their observational findings do not support using hormone therapy for cardiovascular disease prevention and should not guide clinical practice
Therapy initiation timing window
- ▪Women who initiated hormone therapy within 10 years of menopause onset had an estimated 27% lower risk of cardiovascular disease events compared to those who did not initiate therapy
- ▪No clear cardiovascular risk reduction was observed among women who initiated hormone therapy more than 10 years after menopause onset, or among White women
Menopause workplace economic costs
- ▪The Menopause Foundation of Canada estimates that menopause costs the Canadian economy $3.5 billion annually, including $237 million in lost productivity and $3.3 billion in lost income for women
- ▪Manulife data revealed that insurance claims for hormone replacement therapy among Canadian women aged 45-54 soared by 228% over the past five years
Hormone therapy mood improvements
- ▪A retrospective observational study led by NYU Grossman School of Medicine researchers found that systemic hormone therapy was associated with significant improvements in depressive mood, irritability, anxiety, and mental exhaustion
- ▪In the NYU Grossman School of Medicine study, the proportion of menopause patients experiencing severe mood symptoms decreased from 62.3% at baseline to 24.6% at a mean follow-up of 4.5 months
- ▪Systemic hormone therapy is FDA-approved for treating vasomotor symptoms, genitourinary syndrome, and osteoporosis prevention, but it is not FDA-approved for treating mood-related symptoms
Menopause supplement market concerns
- ▪University College London researchers warned that excessive vitamin D in supplements can lead to high calcium levels, while botanical ingredients like black cohosh carry risks of liver toxicity
- ▪A University College London study of 201 menopause supplements found that half did not contain vitamin D, only 23.9% contained calcium, and doses varied widely
Debatable claims
- ▪Governments should tighten regulations on the menopause supplement industry
- ▪Governments should mandate that large employers provide menopause support plans
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