What does this research mean for the field?

Long-term use of combined hormone therapy in postmenopausal women increases the risk of thromboembolism and breast cancer, whereas estrogen-only therapy increases the risk of stroke and gallbladder disease, though both formulations reduce the risk of fractures. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the long-term effects of at least one year of hormone therapy on mortality, cardiovascular disease, cancer, gallbladder disease, fractures, and cognition in perimenopausal and postmenopausal women.

September 7, 2026Cochrane library

Long-term hormone therapy for perimenopausal and postmenopausal women

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Authors

MRMagdalena Bofill Rodriguez LYLi Ning Yong SMSanja Mirkov

Discussion

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Overview

Randomized double-blind trials show distinct risk profiles for long-term hormone therapy in postmenopausal women, indicating critical trade-offs between fracture prevention and vascular risks.

Key Points

To assess the long-term effects of at least one year of hormone therapy on mortality, cardiovascular disease, cancer, gallbladder disease, fractures, and cognition in perimenopausal and postmenopausal women.
Systematic review and meta-analysis of 24 randomized, double-blind trials encompassing 45,660 peri- and postmenopausal participants (mean age over 60 years) receiving hormone therapy or placebo for at least one year.
Nearly 70% of evidence was derived from two major studies (HERS 1998 and WHI 1998) evaluating continuous combined hormone therapy and estrogen-only therapy versus placebo.
In women with an intact uterus (N=16,608; mean 5.6 years follow-up), combined therapy increased risks of stroke (RR 1.39, 95% CI 1.09 to 2.09), venous thromboembolism (RR 2.03, 95% CI 1.55 to 6.64), breast cancer (RR 1.27, 95% CI 1.03 to 1.56), and gallbladder surgery (RR 1.64, 95% CI 1.30 to 2.06), but reduced fractures (RR 0.78, 95% CI 0.71 to 0.86) with little effect on coronary events (RR 1.17, 95% CI 0.95 to 1.44).
In women with prior hysterectomy (N=10,739; mean 7.0 years follow-up), estrogen-only therapy increased risks of stroke (RR 1.33, 95% CI 1.06 to 1.67) and gallbladder surgery (RR 1.78, 95% CI 1.42 to 2.24) and reduced fractures (RR 0.73, 95% CI 0.65 to 0.80), but showed little effect on coronary events (RR 0.94, 95% CI 0.78 to 1.13), venous thromboembolism (RR 1.32, 95% CI 1.00 to 1.74), or breast cancer (RR 0.79, 95% CI 0.61 to 1.01).

Cite This Study

Rodriguez et al. (2026) studied this question.

synapsesocial.com/papers/6a9e8531c3034f961570d71d https://doi.org/10.1002/14651858.cd004143.pub7

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September 7, 2026Cochrane library

Long-term hormone therapy for perimenopausal and postmenopausal women

View Full Paper

Ask AI

Bookmark

Authors

MRMagdalena Bofill Rodriguez LYLi Ning Yong SMSanja Mirkov

Discussion

Member takes

Overview

Randomized double-blind trials show distinct risk profiles for long-term hormone therapy in postmenopausal women, indicating critical trade-offs between fracture prevention and vascular risks.

Key Points

To assess the long-term effects of at least one year of hormone therapy on mortality, cardiovascular disease, cancer, gallbladder disease, fractures, and cognition in perimenopausal and postmenopausal women.
Systematic review and meta-analysis of 24 randomized, double-blind trials encompassing 45,660 peri- and postmenopausal participants (mean age over 60 years) receiving hormone therapy or placebo for at least one year.
Nearly 70% of evidence was derived from two major studies (HERS 1998 and WHI 1998) evaluating continuous combined hormone therapy and estrogen-only therapy versus placebo.
In women with an intact uterus (N=16,608; mean 5.6 years follow-up), combined therapy increased risks of stroke (RR 1.39, 95% CI 1.09 to 2.09), venous thromboembolism (RR 2.03, 95% CI 1.55 to 6.64), breast cancer (RR 1.27, 95% CI 1.03 to 1.56), and gallbladder surgery (RR 1.64, 95% CI 1.30 to 2.06), but reduced fractures (RR 0.78, 95% CI 0.71 to 0.86) with little effect on coronary events (RR 1.17, 95% CI 0.95 to 1.44).
In women with prior hysterectomy (N=10,739; mean 7.0 years follow-up), estrogen-only therapy increased risks of stroke (RR 1.33, 95% CI 1.06 to 1.67) and gallbladder surgery (RR 1.78, 95% CI 1.42 to 2.24) and reduced fractures (RR 0.73, 95% CI 0.65 to 0.80), but showed little effect on coronary events (RR 0.94, 95% CI 0.78 to 1.13), venous thromboembolism (RR 1.32, 95% CI 1.00 to 1.74), or breast cancer (RR 0.79, 95% CI 0.61 to 1.01).

Cite This Study

Rodriguez et al. (2026) studied this question.

synapsesocial.com/papers/6a9e8531c3034f961570d71d https://doi.org/10.1002/14651858.cd004143.pub7

View Full Paper

Ask AI

Bookmark