In a recent study published in the journal JAMA, researchers from the Women’s Health Initiative evaluated the effectiveness of hormone replacement therapy, calcium and vitamin D supplementation, and a low-fat diet in preventing various diseases in postmenopausal women. The study, which included 161,808 women aged 50 to 79, found that these treatments may not be as effective as previously thought in reducing the risk of certain diseases. While hormone replacement therapy was found to help with vasomotor symptoms like hot flashes, it was not effective in preventing cardiovascular disease. Additionally, calcium and vitamin D supplementation did not reduce fractures, and the low-fat diet did not significantly decrease the incidence of breast or colorectal cancer.
The researchers noted that the use of hormone therapy and calcium supplementation has been controversial in the past, with conflicting results from various studies. Dr. Nicole Weinberg, a cardiologist, stated that the data from this study provides helpful information for treating women in different stages of menopause. While hormone therapy may be useful for managing symptoms, it should not be used to prevent cardiovascular disease. Other experts, such as Dr. Cheng-Han Chen, recommend lifestyle changes like a heart-healthy diet and exercise for reducing cardiovascular risk in postmenopausal women instead of relying on hormone replacement therapy.
The study also found that calcium and vitamin D supplementation did not prevent hip fractures in postmenopausal women. While the national dietary guidelines recommend a daily intake of 1,200 mg of calcium and 600 IU of vitamin D, the study participants received 1,000 mg of calcium and 400 IU of vitamin D daily. Additional research has indicated that these supplements may reduce the risk of death from cancer but could potentially increase the risk of death from cardiovascular disease.
The researchers observed that the low-fat diet followed by the participants did not meet the goal of a 20% reduction in total calories from fat. However, they did note a reduction in breast cancer mortality with long-term adherence to the diet. Dr. Adi Katz emphasized the importance of supporting women during the perimenopausal phase, as hormonal fluctuations during this period can impact mental health. It is crucial to recognize and destigmatize conditions like PCOS, PMDD, and PMS that may arise during menopause.
Despite the findings of the study, the researchers acknowledged certain limitations. These include the use of the most common hormone therapy treatment, potential influences from non-study calcium and vitamin D supplements, and the inability to differentiate the effects of reducing fat intake from increasing fruits, vegetables, and grains. Overall, the study provides valuable insights into the effectiveness of menopause treatments in preventing disease and highlights the need for further research in this area to better support women’s health during this transitional phase.