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Starting Estrogen Therapy in Perimenopause Tied to Lower Cancer and Cardiovascular Risks, Study Finds

The observational EHR analysis presented at The Menopause Society has prompted calls for cautious interpretation.

Overview

  • Researchers analyzed more than 120 million electronic health records to compare outcomes when estrogen therapy began during perimenopause, after menopause, or not at all.
  • Use for at least a decade before the final menstrual period was associated with roughly 60% lower odds of breast cancer, heart attack, and stroke compared with later or no use.
  • Initiation after menopause was linked to slightly lower odds of breast cancer and heart attack versus never-users but a 4.9% higher likelihood of stroke.
  • The results were presented at The Menopause Society meeting in Orlando as conference data pending fuller details and peer-reviewed publication.
  • Experts flagged potential biases typical of observational studies and referenced existing guidance, including NICE contraindications and evidence that combined HRT and longer duration raise breast cancer risk.