(Press-News.org) Researchers at Uppsala University have analysed the effects of seven different hormone treatments for menopausal symptoms on the risk of blood clots, stroke and heart attack. The study, which involved around one million women aged between 50 and 58, shows that the risks differ depending on the active substance and how the medicine is taken. Published in the scientific journal BMJ, this is the largest and most comprehensive study of currently prescribed hormonal substances in the world.
“There is concern among women that menopausal hormone therapy increases the risk of cardiovascular disease. This concern is based on older studies conducted more than 20 years ago that only looked at one type of treatment. Since then, many new preparations have been introduced and our study shows that the previous conclusions do not apply to all types of treatments,” says Therese Johansson, postdoctoral researcher and lead author of the study, which was part of her thesis at Uppsala University.
Most women go through menopause between the ages of 50 and 60. Levels of the hormone oestrogen fall sharply, increasing the risk of osteoporosis. The low levels can also contribute to health problems such as hot flushes, mood swings and difficulty sleeping. To counteract these health effects, women may be prescribed hormone replacement therapy involving medicines containing hormones or hormone-like substances.
In Sweden alone, hundreds of thousands of women currently use hormone replacement therapy and this type of treatment has been available since the 1970s. At that time, there was only one type of hormone replacement therapy and when a major study in the 1990s showed that it increased the risk of cardiovascular disease, its use rapidly declined. Since then, new preparations have entered the market, and following this, the use of hormone replacement therapy in connection with menopause has increased significantly in recent years.
In the new study, the researchers looked at seven different types of currently used hormone replacement treatments, administered via tablets, hormone patches or hormone-releasing IUDs. The study is based on all prescriptions for hormone replacement therapy in Sweden from 2007 to 2020 and covers nearly one million women aged 50 to 58. The women were monitored for two years after starting hormone replacement therapy. The risk of blood clots and cardiovascular disease was compared between women who had and had not collected a prescription medicine for hormone replacement therapy.
The results show clearly that the risks of hormone replacement therapy vary depending on the type of treatment.
For example, the synthetic hormone tibolone, which mimics the effects of the body’s natural hormones, was linked to an increased risk of both heart attack and stroke, but not to an increased risk of blood clots. The risk of heart attack or stroke due to tibolone is estimated at one in a thousand women.
Combined preparations containing both oestrogen and progesterone instead increase the risk of blood clots, including deep vein thrombosis. Blood clots form in the veins and can break loose and travel with the circulation to the lungs, leading to pulmonary embolism. The researchers estimate that the risk of deep vein thrombosis resulting from this combined preparation is about seven per thousand women per year.
“It is important that both doctors and women are aware of the risks of menopausal hormone therapy and, in particular, that the existing drugs carry different risks of blood clots and cardiovascular disease. Tibolone in particular was associated with an increased risk of stroke and heart attack. Tibolone is used in Europe but is not approved in countries such as the United States. We hope that our study will lead to the drug being withdrawn from use here as well,” says Åsa Johansson, research group leader at Uppsala University and SciLifeLab, and the study’s senior author.
During the period of the study, 2007–2020, an increase in the use of hormone patches of about 50 per cent was observed, and these preparations were not linked to the same higher risk. The increased use of safer alternatives, such as patches, is an important step forward in reducing the risk of cardiovascular disease among menopausal women.
“The next step in our research will be to develop strategies to identify which women are at increased risk of certain diseases in connection with using hormonal drugs. In this way, we can guide patients to the most appropriate medicine for each individual and drastically reduce the number of side effects,” Åsa Johansson says.
Johansson T. et al.; ‘Contemporary menopausal hormone therapy and risk of cardiovascular disease: Swedish nationwide register based emulated target trial’ BMJ 2024;387:e078784
END
Different menopausal hormone treatments pose different risks
2024-11-28
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
Novel CAR T cell therapy obe-cel demonstrates high response rates in adult patients with advanced B-cell ALL
2024-11-27
Patients with relapsed or refractory CD19-positive B-cell acute lymphoblastic leukemia (ALL) who were treated with the novel anti-CD19 chimeric antigen receptor (CAR) T cell therapy, obecabtagene autoleucel (obe-cel), experienced high response rates and most did not need a subsequent stem cell transplant (SCT), according to results from the Phase Ib/II FELIX trial co-led by researchers at The University of Texas MD Anderson Cancer Center.
The findings, published today in the New England Journal of Medicine, ...
Clinical trial at Emory University reveals twice-yearly injection to be 96% effective in HIV prevention
2024-11-27
For oral medications that prevent new HIV infection to be effective, the patient must take certain actions, including attending doctor’s visits every three months and – most importantly – consistency.
These daily oral antiretrovirals, more commonly referred to as PrEP (pre-exposure prophylaxis), such as Truvada®, are extremely effective at HIV prevention, but only if they are taken daily as directed. Truvada’s efficacy is greatly compromised when taken inconsistently.
However, results from a recent Gilead-funded clinical trial (Purpose-2) led by physicians at Emory University ...
Discovering the traits of extinct birds
2024-11-27
Looking to inform the conservation of critically endangered bird species, University of Utah biologists completed an analysis identifying traits that correlate with all 216 bird extinctions since 1500.
Species most likely to go extinct sooner were endemic to islands, lacked the ability to fly, had larger bodies and sharply angled wings, and occupied ecologically specific niches, according to research published this month.
While some of these findings mirror previous research on extinct birds, they are the first to correlate bird traits with the timing of ...
Are health care disparities tied to worse outcomes for kids with MS?
2024-11-27
MINNEAPOLIS – People who develop multiple sclerosis (MS) as children and grow up in less advantaged neighborhoods may have a larger volume of inflammation and brain tissue loss on imaging than those who grow up in more advantaged neighborhoods, according to a study published in the November 27, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology.
MS rarely develops in children. About 5% of people with MS are diagnosed before age 18.
In addition to neighborhood location, worse brain imaging outcomes were also seen ...
For those with CTE, family history of mental illness tied to aggression in middle age
2024-11-27
EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, WEDNESDAY, NOVEMBER 27, 2024
MINNEAPOLIS – People who have chronic traumatic encephalopathy (CTE) who have a family history of mental illness may have a higher risk of aggression in middle age, according to a study published in the November 27, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology.
CTE is a neurodegenerative disease associated with repeated head injuries, often seen in athletes and military personnel, that can lead to mood changes and dementia.
“This ...
The sound of traffic increases stress and anxiety
2024-11-27
Manmade sounds such vehicle traffic can mask the positive impact of nature soundscapes on people’s stress and anxiety, according to a new study published November 27, 2024, in the open-access journal PLOS ONE by Paul Lintott of the University of the West of England, U.K., and Lia Gilmour of the Bat Conservation Trust, U.K.
Existing research shows that natural sounds, like birdsong, can lower blood pressure, heart, and respiratory rates, as well as self-reported stress and anxiety. Conversely, anthropogenic soundscapes, like traffic or aircraft noise, are hypothesized to have negative effects on human health and wellbeing in a variety ...
Global food yields have grown steadily during last six decades
2024-11-27
Contrary to widespread concerns that global crop yields have stagnated in recent decades, a comprehensive study of worldwide food production finds yields have continued to grow at roughly the same rate since the 1960s. John Baffes of the World Bank and Xiaoli Etienne of the University of Idaho, U.S., report these findings on November 27, 2024, in the open-access journal PLOS ONE.
Almost 10 billion people are expected to inhabit Earth by 2050, so agricultural production will become increasingly critical ...
Children who grow up with pets or on farms may develop allergies at lower rates because their gut microbiome develops with more anaerobic commensals, per fecal analysis in small cohort study
2024-11-27
Children who grow up with pets or on farms may develop allergies at lower rates because their gut microbiome develops with more anaerobic commensals, per fecal analysis in small cohort study
###
Article URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0313078
Article Title: Gut microbiota markers in early childhood are linked to farm living, pets in household and allergy
Author Countries: Sweden
Funding: This work was supported by the Region Västra Götaland (agreement concerning medical research and education – ALF), https://www.alfvastragotaland.se [ALFGBG966243] [ALFGBG720181] ...
North American Early Paleoindians almost 13,000 years ago used the bones of canids, felids, and hares to create needles in modern-day Wyoming, potentially to make the tailored fur garments which enabl
2024-11-27
North American Early Paleoindians almost 13,000 years ago used the bones of canids, felids, and hares to create needles in modern-day Wyoming, potentially to make the tailored fur garments which enabled their dispersal into these colder climates
###
Article URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0313610
Article Title: Early Paleoindian use of canids, felids, and hares for bone needle production at the La Prele site, Wyoming, USA
Contact: Spencer Pelton, spencer.pelton@wyo.gov, Ph. +1 307 399 2827
Author Countries: U.S.
Funding: Funding for this project includes the National Science Foundation (award #1947297), the ...
Higher levels of democracy and lower levels of corruption are associated with more doctors, independent of healthcare spending, per cross-sectional study of 134 countries
2024-11-27
Higher levels of democracy and lower levels of corruption are associated with more doctors, independent of healthcare spending, per cross-sectional study of 134 countries.
###
Article URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal. pgph.0003656
Article Title: The relationship between democracy and corruption and the global physician workforce
Author Countries: Canada
Funding: The authors received no specific funding for this work. END ...