Hormone-replacement therapy started soon after menopause seems safe and lowers some markers of heart-disease risk while significantly reducing hot flashes, according to a multicenter trial published in the Annals of Internal Medicine on Monday.
Use of hormone-replacement drugs fell sharply after 2002 when the Women's Health Initiative, a major government research trial, found that they raised the risk of heart attack and stroke in older women.
Some experts speculated that the ill effects might be due to the age of the women in the study, known as the WHI; most were in their 60s and 10 years or more past menopause. Some experts also believed that other forms of hormone therapy might have different effects.
The new study, commissioned by the privately funded Kronos Longevity Research Institute, aimed at testing those hypotheses.
Researchers at nine academic centers enrolled 727 healthy women aged 42 to 58 who were no more than three years past menopause. They were randomized to take a form of hormone therapy – either oral estrogen or an estrogen patch – or a placebo.
Those on active estrogen also took a form of progesterone if they still had a uterus, to protect against uterine cancer.
Heart attacks and strokes are rare in that age group, so the study examined markers of cardiovascular disease instead.
After four years, there was no change in the buildup of artery plaque or coronary calcium in either the estrogen or placebo groups.