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Coronary Events in Women during Menopause and the Effects of HRT

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Review on January 21, 2010

Many women turn to hormone replacement therapy to treat a host of uncomfortable side effects which appear during menopause. Although research has show this treatment to bring benefits such as reduced risk of osteoporosis and cardiovascular problems post menopause, recent research has highlighted possible problems with this type of menopause treatment which few doctors and medical researchers can agree on.

In a review of the Heart and Estrogen/Progestin Replacement Study (HERS) by Dr. John Blakely results assessed so that new conclusions could be found which may help to diminish cardiovascular problems in women taking hormone replacement therapy. The original research found that in the first six months of hormone replacement therapy women going through menopause, who had already been diagnosed with coronary artery disease, had an increased risk of coronary events. As time went by the risk of cardiovascular events were reduced in these women but the results of the first six months of the trail were surprising as hormone replacement therapy was widely thought to only improve women's coronary health during and after menopause.

Dr. Blakely, upon reviewing these results, concluded that hormone replacement therapy was the cause of this increased risk during the first six months of treatment for women during menopause, and that the reasons why this risk had not been highlighted before was because other studies had not recognized women as being in danger during this time.

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A reply to this comment by the Menopause Special Interest Group of Birmingham, Alabama, on behalf of the American Society of Reproductive Medicine disagreed with Dr. Blakely's comments. This reply suggested that this six month period was an anomaly which distracted from the rest of the results of this study, which showed that cardiovascular events were actually significantly cut in hormone replacement therapy users during the four year follow up. This comment also highlighted the need to wait for ongoing research into the effects of hormone replacement therapy to be completed in order to find correct conclusions about this topic.

In reply to this comment, Dr. Blakely once again suggests that the results of HERS do in fact show a substantial risk to women with pre-diagnosed coronary problems. He concludes that there are two effects for patients taking hormone replacement therapy during menopause, the primary, which is harmful and the later one which is positive. It is important for women to be aware of this risk before starting hormone replacement therapy.

Women who are currently going through menopause or are in post menopause should consult their doctors to find the most up to date information surrounding the cardiovascular risks involved with early hormone replacement therapy. Doctors may also be able to suggest alternative menopause treatments which do not carry the same risks as this type of treatment.