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Cholesterol

Estrogen-Based Hormone Therapy May Offer Cardiovascular Benefits to Postmenopausal Women

Strategic Insights

— 1 min read

Women considering hormone therapy to alleviate menopausal symptoms must weigh the potential benefits to heart health, a topic of ongoing debate. Matthew Nudy, assistant professor of medicine at Penn State College of Medicine, notes that the long-term impact of hormone therapy on cardiovascular health has been unclear. A recent study led by Nudy, examining data from the Women's Health Initiative (WHI), has provided new insight into the relationship between hormone therapy and cardiovascular health, suggesting that estrogen-based therapies may help improve cardiovascular biomarkers.

Key Takeaways:

  • Hormone therapy, specifically estrogen-based therapies, may lower harmful low-density lipoprotein (LDL) cholesterol and insulin resistance, improving cardiovascular health.
  • Estrogen treatment reduces lipoprotein(a), a strong genetic risk factor for heart disease, by 15% in estrogen-only groups and 20% in combined hormone therapy groups.
  • The study analyzed data from 2,696 postmenopausal women participating in a WHI oral hormone therapy trial over six years.
  • Cardiovascular biomarkers, such as LDL cholesterol, total cholesterol, and insulin resistance, showed reductions in both estrogen-only and combined therapy groups.
  • HDL cholesterol ("good") cholesterol increased by 13% and 7% in the estrogen-only and estrogen-plus-progesterone groups, respectively.
  • Triglycerides and coagulation factors showed increases, highlighting a complex risk-benefit profile.
  • The study observed significant reductions in lipoprotein(a) levels in certain racial and ethnic groups, with American Indian and Alaska Native participants showing a 41% reduction and Asian or Pacific Islander participants showing a 38% reduction.
  • Differences in estrogen formulations, such as conjugated equine estrogens and transdermal estrogen, may affect cardiovascular biomarkers.
  • The study suggests that hormone therapy may be a useful factor in reducing heart disease risk in healthy menopausal women, but individuals should consult a doctor before initiating therapy.

Statistics:

  • LDL cholesterol decreased by approximately 11% in both estrogen-only and combined therapy groups.
  • Total cholesterol and insulin resistance also showed reductions in both groups.
  • HDL cholesterol ("good" cholesterol) rose by 13% and 7% in the estrogen-only and estrogen-plus-progesterone groups, respectively.
  • Lipoprotein(a) levels decreased by 15% and 20% in estrogen-only and combined therapy groups, respectively.
  • Triglycerides and coagulation factors increased in both groups.
  • The study analyzed data from 2,696 women over six years, a total of 10% of the trial's participants.

Sources:

  • Long-Term Changes to Cardiovascular Biomarkers After Hormone Therapy in the Women's Health Initiative Hormone Therapy Clinical Trials - (https://journals.lww.com/greenjournal/fulltext/2025/04000/long_term_changes_to_cardiovascular_biomarkers.1.aspx)
  • Medindia

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