Early Menopause Hormone Therapy Cuts Heart Risk by Up to 49%, New Study Finds
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- Studi terbaru dalam JAMA Internal Medicine menemukan bahwa memulai terapi hormon saat perimenopause atau awal pascamenopause dapat menurunkan risiko penyakit kardiovaskular hingga 22%.
- Efek perlindungan paling kuat terlihat pada wanita yang memulai terapi dalam 10 tahun setelah menopause, dengan penurunan risiko 27%, dan pada wanita kulit hitam mencapai 49%.
- Temuan ini menegaskan pentingnya waktu inisiasi terapi hormon dan memberikan implikasi bagi kebijakan kesehatan wanita di Indonesia, meskipun masih diperlukan uji klinis lebih lanjut.
Starting hormone therapy during perimenopause or early postmenopause can reduce the risk of cardiovascular disease by up to 22% compared with those who do not undergo therapy, according to a study published in JAMA Internal Medicine. The findings highlight the importance of the timing of hormone therapy initiation in protecting women's heart health.
The research, which analyzed 20 years of data from more than 2,700 participants in the SWAN (Study of Women’s Health Across the Nation) project, shows that women who started hormone therapy within 10 years after menopause experienced a 27% reduction in heart disease risk. Strikingly, the greatest benefit was found in Black women, with a risk reduction reaching 49%. This difference underscores the need for approaches that take race and ethnicity into account in medical recommendations.
Samar R. El Khoudary, the lead researcher from Virginia Commonwealth University, explained that vasomotor symptoms such as hot flashes and night sweats are common during the menopause transition and are linked to future cardiovascular risk. "Previous research on hormone therapy and cardiovascular disease has largely focused on postmenopausal women, so there is less evidence on perimenopausal and early postmenopausal women," she said. El Khoudary added that this study draws on long-term SWAN data to explore whether the timing of hormone therapy initiation plays an important role.
"These findings suggest that the relationship between menopausal hormone therapy and cardiovascular disease may differ depending on when therapy is started and across different racial and ethnic groups. The stronger effect in women who started therapy within 10 years after menopause is consistent with the possibility of a window of time during the menopause transition and early postmenopause when the cardiovascular effects of hormone therapy differ," El Khoudary said.
Although the results are promising, El Khoudary cautioned that the study is observational, so residual confounding or differences between groups may influence the findings. "These results need to be interpreted carefully and confirmed in future clinical trials," she stressed.
Dr. Jennifer Wong, a cardiologist at MemorialCare Heart and Vascular Institute who was not involved in the study, welcomed the findings. According to her, starting hormone therapy earlier in the menopause transition may have cardiovascular benefits for certain women, although further research is still needed to determine who benefits most. "Hormonal changes during perimenopause and menopause can coincide with changes in cardiovascular risk factors, such as high blood pressure, abnormal cholesterol, and elevated fasting blood glucose," she explained. Wong emphasized that menopause is not a disease, but it is an important time to pay attention to heart health.
Dr. Prudence Hall, an obstetrician and gynecologist, also highlighted the benefits of hormone therapy. She explained that estradiol, a type of estrogen, helps lower blood sugar and stress, and is anti-inflammatory and lowers LDL cholesterol. "The underlying causes of chronic diseases such as heart disease, high blood pressure, and stroke all decrease, as do Alzheimer's disease, diabetes, many cancers, and death from all causes," she said. Hall added that proper management of menopause will determine quality of life for the next 40-50 years.
For Indonesia, these findings have significant implications. With a large female population and growing awareness of menopause health, this information could encourage further discussion about safe and effective hormone therapy. However, access to hormone therapy and understanding of its risks and benefits remain challenges. Better education for health workers and the general public is needed to ensure appropriate decision-making.
Looking ahead, the question is whether these findings will change clinical guidelines and how they would be applied in a country with diverse genetic and lifestyle profiles such as Indonesia. Further clinical trials involving Asian populations, including Indonesia, are urgently needed to confirm the benefits and safety of hormone therapy in this group.
