Menopausal hormone therapy and long term mortality: nationwide, register based cohort study

Area of Science:

• Reproductive Medicine
• Public Health
• Epidemiology

Background:

• Menopausal hormone therapy (MHT) is widely used for managing menopausal symptoms.
• Concerns persist regarding MHT's impact on long-term mortality.
• Robust evidence is needed to clarify the association between MHT and all-cause mortality.

Purpose of the Study:

• To investigate the association between menopausal hormone therapy use and all-cause mortality.
• To assess cause-specific mortality risks in relation to MHT use.
• To evaluate MHT's impact on mortality in women who underwent bilateral oophorectomy.

Main Methods:

• Nationwide, registry-based cohort study in Denmark.
• Included women born 1950-1977, followed from age 45 until July 2023.
• Used Cox regression to estimate adjusted hazard ratios for mortality, controlling for numerous covariates.

Main Results:

• MHT use was associated with a slightly reduced overall mortality hazard ratio (0.96; 95% CI 0.93-0.98).
• No increased mortality risk was observed across different durations of MHT use, with some durations showing reduced risk.
• Among women who underwent bilateral oophorectomy, MHT use was linked to a 27-34% lower mortality hazard.

Conclusions:

• This study found no evidence that menopausal hormone therapy increases the risk of all-cause mortality.
• Findings suggest MHT is not associated with increased mortality, even with prolonged use.
• MHT may be associated with reduced mortality in specific subgroups, such as post-oophorectomy women.