Hormone therapy users in menopause study reported healthier habits
A Menopause study of more than 10,000 women links hormone therapy use with diet and activity patterns, while experts warn the finding may reflect healthier users.
By Priya Raghavan · Science Reporter
3 min read
Postmenopausal women using hormone therapy were more likely to report some healthy habits than women who had never used it, according to a new observational study published in Menopause. The finding could affect how researchers interpret past links between hormone therapy and health outcomes, because lifestyle differences may help explain some of those associations.
The study, described by The Menopause Society, examined more than 10,000 women and compared menopause and hormone therapy status with modifiable health behaviors. Researchers focused on diet, physical activity and sleep duration, all factors that can affect chronic disease risk.
The Menopause Society said menopause is associated with a higher risk of chronic diseases and with symptoms such as hot flashes and urogenital problems. Hormone therapy is used to treat some menopause symptoms, but researchers said it remains unclear whether hormone therapy changes health outcomes directly or whether observed effects may be tied partly to differences in health behavior.
Diet, exercise and sleep patterns differed
In the cross-sectional analysis, postmenopausal women who had never used hormone therapy reported eating fewer fruits and vegetables, according to the researchers. Those never-users were also 19% less likely to meet guidelines for strength-based activity.
Sleep findings were more mixed. The researchers reported that postmenopausal women who had never used hormone therapy had shorter sleep duration. Compared with premenopausal and perimenopausal women, the odds of meeting sleep guidelines were 14% lower among postmenopausal never-users, 26% lower among current hormone therapy users and 24% lower among past users.
The researchers said the sleep results may relate to hormonal changes after menopause, including higher follicle-stimulating hormone levels among postmenopausal women not using hormone therapy and lower estradiol levels associated with menopause. They also noted that hot flashes and urogenital symptoms can disrupt sleep and that hormone therapy may ease some of those symptoms.
Researchers caution against reading causation into the results
Because the study was observational and cross-sectional, it does not show that hormone therapy causes healthier behavior. Dr. Stephanie Faubion, medical director for The Menopause Society, said the findings show that women using hormone therapy tend to have healthier overall lifestyles, but she cautioned that “healthy-user bias” is likely a major factor.
Faubion said women who choose hormone therapy may differ from nonusers in ways that affect health, including socioeconomic resources, access to medical care and health literacy. She said that kind of bias helps explain why earlier observational research suggested cardiovascular benefits from hormone therapy that later randomized controlled trials did not confirm.
The study was published under the title “Menopause and hormone therapy in relation to dietary intake, physical activity, and sleep, and meeting lifestyle guidelines.” The Menopause Society said the results add evidence that hormone therapy status should be considered when studying lifestyle and health risks during and after the menopause transition.
This story draws on original reporting from Medical Xpress.