The risk of heart disease is increased in postmenopausal women, whether the menopause is natural, surgical, or premature. This increasing risk may be related to the loss of estrogens after menopause. Hormone therapy (HT) is treatment with estrogen, either alone or with another hormone called progestin. HT may be prescribed when women experience symptoms from menopause.

A recent study examined whether postmenopausal women with CHD who take HT experience fewer CHD events than women who have CHD and do not take HT. The Heart and Estrogen/Progestin Replacement Study (HERS) found that:

• In the first year of the study, women receiving HT had more CHD events than those not taking it, despite a modest drop in their LDL-cholesterol and a rise in their HDL-cholesterol levels.
• By the fourth and fifth years of the study, women in the HT group experienced fewer events than women not taking HT.
• Women in the HT group experienced more blood clots and gallbladder disease.

Overall, HERS found that women taking HT did not benefit from a lower rate of CHD events. Furthermore, results of the Women's Health Initiative postmenopausal hormone therapy trials among healthy women have shown that hormone therapy should not be used to prevent heart disease. Postmenopausal women who are judged by their physician to need drug treatment to reduce their risk for a heart attack should consider cholesterol-lowering drugs instead of HT, since cholesterol-lowering drugs have been shown to be safe and effective in lowering cholesterol and reducing CHD risk in such women.