Researchers discovered that postmenopausal women who used hormone replacement therapy during their transition through menopause were biologically younger than those who didn't use hormones.
Hormone replacement therapy (HRT), AKA menopause hormone therapy (MHT), has undergone significant scrutiny over the past 20 years. The controversies over its safety began shortly after research published in 2002 found that hormone replacement was linked to an increased risk of breast cancer and cardiovascular disease.
However, several studies since then have found that for most women, the benefits of HRT outweigh the risks, and using hormone replacement does not increase an individual's mortality risk.
For example, a 2022 study reported that women who started HRT before age 60 and/or initiated hormone therapy within the 10 years since menopause had a 30 to 50% lower risk of all-cause mortality and coronary heart disease.
Now, a new study published on August 29 in JAMA Network Open may have uncovered at least one reason why hormone therapy appears to have these protective effects.
According to the study's authors, HRT use might help postmenopausal women remain biologically younger than their actual age.
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The study involved 117,763 postmenopausal women with an average age of 60 who were registered in the UK Biobank.
The scientists measured the participants' aging biomarkers to determine biological age and conducted surveys to identify women who had used hormone therapy. They also gathered information on income and other factors to estimate socioeconomic status.
The surveys showed that 47,461 (40.3%) had used hormone therapy at some point during their menopausal years.
After accounting for factors that could influence the results, the researchers found that women who used hormone therapy were biologically younger than those who did not use hormones.
Specifically, hormone therapy was associated with a 0.17-year reduction in biological age compared to chronological age.
Moreover, starting hormones at age 55 or older reduced biological age by 0.32 years.
The study also showed that the benefit of hormone replacement therapy on biological aging was more significant in women with lower socioeconomic status.
For example, participants with a higher education level who used hormone therapy had a biological age of 0.08 years younger, while women with lower education levels were 0.23 years younger than individuals who did not use HRT.
The scientists suggest that people with a higher socioeconomic status may have an advantage, health-wise, due to greater access to healthcare and other aspects of wellness. This could explain the smaller changes in biological age among participants in this group.
In addition, the study found that women who used hormone therapy for four to eight years were biologically 0.25 years younger than their actual age.
The 0.25 years of delayed aging observed in our study could translate to approximately 2.25% decreased risk of all-cause mortality and 5% decreased risk of cause-specific mortality,
The research team suggests hormone therapy's influence on biological aging might partially explain the findings of previous studies, which found links between hormone therapy and lower mortality risks.
However, the data on hormone therapy use was self-reported, and the researchers measured biological age at a single point and not throughout the participants' lives. Moreover, the study did not examine the dose or type of hormone therapy used. These and other limitations could have had an impact on the results.
The researchers note that more investigations are needed to confirm the findings and understand the risks and benefits, especially since earlier research found potential associations between hormone replacement therapy and breast cancer.
However, overall, the scientists believe their findings provide more evidence that HRT use could be important for healthy aging and a strategy to reduce socioeconomic-related health disparities in postmenopausal women.
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