Hormone replacement therapy

By the Evernow Medical Group Updated November 13, 2020

Annual health outcomes per 10,000 women

Data from the following studies:

  • Women with uterus taking oral estrogen and progesterone

  • Women with hysterectomy taking oral estrogen

Invasive breast cancer

Risk increases for women without a hysterectomy and decreases for women with a hysterectomy.

45
HRT
36
No HRT

9 additional cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 16608*
30
HRT
37
No HRT

7 fewer cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 10739*

Diabetes

HRT prevents diabetes while taking therapy.

72
HRT
88
No HRT

16 fewer cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 16608*
134
HRT
155
No HRT

21 fewer cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 10739*

Deaths from Alzheimer’s and dementia

HRT prevents deaths from Alzheimer’s and dementia among women with a hysterectomy, both during and beyond therapy.

N/A
HRT
N/A
No HRT

The risks were studied but no impact was detected.

  • No statistical significance
  • Population without hysterectomy
  • Study group size 16608*
240
HRT
320
No HRT

80 fewer cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 10739*

All cause mortality

HRT (estrogen) reduces death during therapy for women with a hysterectomy.

N/A
HRT
N/A
No HRT

The risks were studied but no impact was detected.

  • No statistical significance
  • Population without hysterectomy
  • Study group size 16608*
28
HRT
39
No HRT

11 fewer cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 10739*

Endometrial cancer

HRT (estrogen+progestin) prevents endometrial cancer both during and beyond taking therapy for women without hysterectomy.

7
HRT
10
No HRT

3 fewer cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 16608*
N/A
HRT
N/A
No HRT

Endometrial cancer is not possible with this population

  • There is no data for this population
  • Population with hysterectomy

Venous thromboembolism

HRT prevents venous thromboembolism both during and beyond therapy.

19
HRT
22
No HRT

3 fewer cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 1395
  • Transdermal HRT
  • Age 40-79**
19
HRT
22
No HRT

3 fewer cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 1824
  • Transdermal HRT
  • Age 55-64**

Coronary heart disease

HRT is not associated with risk of coronary heart disease.

N/A
HRT
N/A
No HRT

The risks were studied but no impact was detected.

  • Not statistically significant
  • Population without hysterectomy
  • Study group size 16608*
N/A
HRT
N/A
No HRT

The risks were studied but no impact was detected.

  • Not statistically significant
  • Population with hysterectomy
  • Study group size 10739*

Colorectal cancer

HRT (estrogen+progestin) prevents colorectal cancer during and beyond taking therapy for women without hysterectomy

10
HRT
17
No HRT

7 fewer cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 16608*
N/A
HRT
N/A
No HRT

The risks were studied but no impact was detected.

  • No impact measured
  • Population with hysterectomy
  • Study group size 10739*

Hip fracture

HRT prevents hip fractures during therapy.

11
HRT
17
No HRT

6 fewer cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 16608*
13
HRT
19
No HRT

6 fewer cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 10739*

Bone fracture

HRT prevents bone fractures during therapy.

161
HRT
212
No HRT

51 fewer cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 16608*
153
HRT
214
No HRT

61 fewer cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 10739*

Gallbladder disease

HRT increases risk of gallbladder disease. Numbers are shown for oral HRT, but the risk is lower with transdermal HRT.**

131
HRT
84
No HRT

47 additional cases per year per 10,000 women

  • Statistically significant
  • Population without hysterectomy
  • Study group size 16608*
164
HRT
106
No HRT

58 additional cases per year per 10,000 women

  • Statistically significant
  • Population with hysterectomy
  • Study group size 10739*

*The study employed just one route of administration (oral), one formulation of estrogen (conjugated equine estrogens [CEE], 0.625 mg), and only one progestogen (medroxyprogesterone acetate [MPA], 2.5 mg), with limited enrollment of women with bothersome vasomotor symptoms (VMS; hot flashes, night sweats) who were aged younger than 60 years or who were fewer than 10 years from menopause onset—the group of women for whom hormone replacement therapy is primarily indicated.

** A Retrospective study of 80,396 women aged 40-79 with a primary diagnosis of venous thromboembolism (VTE), matched to 391,494 women in the control arm. The study looked for women who had been recently exposed to oral hormone replacement therapy or transdermal hormone replacement therapy to see if there was a significantly increased risk of venous thromboembolism compared with no exposure .