---
title: "Early menopausal hormone therapy linked to lower cardiovascular disease risk, SWAN study analysis"
id: "medical-news-today-0-start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study"
canonical_url: "https://medichelpline.com/clinical-feed/medical-news-today-0-start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study"
content_type: "clinical_feed_article"
specialty: "Cardiology"
source_name: "Medical News Today"
source_url: "https://www.medicalnewstoday.com/articles/start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study-suggests/"
published_at: "2026-09-16T11:00:00.000Z"
evidence_level: "Verified Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Early menopausal hormone therapy linked to lower cardiovascular disease risk, SWAN study analysis
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/medical-news-today-0-start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study
- **Specialty:** [Cardiology](https://medichelpline.com/clinical-feed/cardiology.md)
- **Primary Source:** Medical News Today
- **Source URL:** [Original Journal Publication](https://www.medicalnewstoday.com/articles/start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study-suggests/)
- **Published At:** 2026-09-16T11:00:00.000Z
- **Evidence Rating:** Verified Feed
## Executive GIST (TL;DR)
- Researchers analyzed 20 years of SWAN (Study of Women’s Health Across the Nation) data for more than 2,700 women with self‑reported vasomotor symptoms and no prior heart disease to assess the association between **menopausal hormone therapy (MHT)** and future **cardiovascular disease** risk. - Women who initiated hormone therapy during perimenopause or early postmenopause had an overall estimated 22% lower risk of cardiovascular disease compared with women not taking hormone therapy. - The protective association was stronger when therapy began within 10 years of menopause onset, with an estimated 27% lower heart disease risk for early initiators. - The largest estimated benefit appeared among Black women in the cohort, who had an estimated 49% lower cardiovascular disease risk with hormone therapy in this analysis. - Study participants self‑reported vasomotor symptoms (hot flashes, night sweats) and their hormone therapy use; researchers used observational SWAN data rather than randomized trial assignment. - Authors emphasize that because the analysis is observational, residual confounding or other between‑group differences could influence results; they call for confirmation in clinical trials. - Independent clinicians noted the findings reinforce prior evidence that timing of MHT initiation may matter and that vasomotor symptoms can signal elevated future cardiovascular risk and coincide with adverse metabolic changes. - Proposed biological mechanisms discussed by clinicians include effects of **estradiol** on glucose regulation, anti‑inflammatory action, and favorable changes in LDL, APOB and Lp(a) subparticles, which could reduce atherosclerotic plaque progression. - Experts recommend individualized care: MHT may be appropriate for some symptomatic women but is not universally recommended; decisions should consider cardiovascular risk, symptom severity, and patient preferences. - The study fills gaps in evidence by including perimenopausal women and examining timing of initiation, but details such as specific hormone formulations, doses, routes of administration, and trial‑level outcomes were not reported in the source article.
## Clinical Analysis & Structured Key Points
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Pinterest](https://www.pinterest.com/pin/create/button/?url=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2Fstart-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study-suggests&media=https%3A%2F%2Fmedia.post.rvohealth.io%2Fwp-content%2Fuploads%2Fsites%2F3%2F2026%2F09%2Fgetty_1342134430_header_1296x728-1024x575.jpg&description=Menopause%3A%20Early%20HRT%20start%20may%20lower%20heart%20disease%20risk%20by%2027%25 "Share on Pinterest")Starting menopausal hormone therapy early may lower heart disease risk by 27%, a study suggests. SDI Productions/ Getty Images * **Previous research shows that women are generally at a higher risk for cardiovascular disease after reaching menopause.** * **Past studies have found that taking hormone therapy for**menopause** may help lower a woman’s heart disease risk. ** * **A new study found that women who start hormone replacement therapy during perimenopause or early postmenopause may decrease their cardiovascular disease risk by 22%.** Previous research shows that women are generally at a [higher risk](https://pmc.ncbi.nlm.nih.gov/articles/PMC12156203/) for cardiovascular disease after reaching [menopause](https://www.medicalnewstoday.com/articles/155651). This increased heart disease risk is due to several different factors, including lower levels of the hormone [estrogen](https://pmc.ncbi.nlm.nih.gov/articles/PMC13100506/), [stiffening of blood vesselsTrusted Source](https://pubmed.ncbi.nlm.nih.gov/40413990/), and changes in [cholesterol](https://pmc.ncbi.nlm.nih.gov/articles/PMC11663658/) and [general metabolismTrusted Source](https://pubmed.ncbi.nlm.nih.gov/41190382/). Past studies have found that taking [hormone replacement therapy (HRT)](https://www.medicalnewstoday.com/articles/181726), also known as [menopausal hormone therapy (MHT)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12652300/), may help [lower a woman’s heart disease riskTrusted Source](https://pubmed.ncbi.nlm.nih.gov/35594469/) during and after menopause. Now, a new study published in the journal [JAMA Internal MedicineTrusted Source](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2853611) adds to what we know about the link between hormone therapy and heart disease risk. Researchers report that women who start hormone therapy during [perimenopause](https://www.medicalnewstoday.com/articles/318660) or early postmenopause may decrease their cardiovascular disease risk by 22%, compared to those not taking hormone therapy. ## Analyzing 20 years of menopause-related health data For this study, researchers analyzed 20 years of health data for more than 2,700 women who were part of the [SWAN (Study of Women’s Health Across the Nation) project](https://www.swanstudy.org/). Female participants selected for this study self-reported menopause-related [vasomotor symptoms](https://www.medicalnewstoday.com/articles/317801), such as [hot flashes](https://www.medicalnewstoday.com/articles/327481) and [night sweats](https://www.medicalnewstoday.com/articles/296818), and had no prior heart disease diagnosis. They also self-reported whether or not they were on hormone therapy. “Vasomotor symptoms, such as hot flashes and night sweats, are common during the menopause transition and have been associated with future cardiovascular risk,” [Samar R. El Khoudary](https://sph.vcu.edu/about/portfolio/details/elkhoudarys/), PhD, MPH, BPharm, FAHA, professor and chair of the Department of Epidemiology, and director of Women’s Public Health Research Initiatives at the School of Public Health at Virginia Commonwealth University, and co-senior author of this study, told _Medical News Today_. “At the same time, much of the previous research on MHT and cardiovascular disease has focused on women who were already postmenopausal, leaving less evidence about women during perimenopause and early postmenopause, when hormonal changes and symptoms are particularly prominent,” El Khoudary added. “We saw an opportunity to use the long-term SWAN data to examine this question specifically among women with vasomotor symptoms and to explore whether the timing of hormone therapy initiation matters,” she told us. ## Hormone therapy may lower heart disease risk by 22% At the study’s conclusion, researchers found that women who started hormone therapy during perimenopause or early postmenopause experienced a cardiovascular disease risk reduction of 22%, compared to those not taking hormone therapy. **Scientists also discovered the protective effect of hormone therapy was strongest in women who started it within 10 years of menopause onset for a 27% lower heart disease risk.** Researchers also noted the hormone therapy protective benefit was highest among Black women, lowering their cardiovascular disease risk by 49%. > “These findings suggest that the estimated association between menopause hormone therapy and cardiovascular disease may differ depending on when treatment is initiated and across different racial and ethnic groups. The stronger estimated effect among women who initiated therapy within 10 years of menopause onset is consistent with the possibility that there may be a window during the menopause transition and early postmenopause when the cardiovascular effects of hormone therapy are different.” > – Samar R. El Khoudary, PhD, MPH, BPharm, FAHA “Because this was an observational study, residual confounding or other differences between groups could also contribute to the findings,” El Khoudary continued. “These results therefore need to be interpreted with caution and to be confirmed in future clinical trials.” ## Evidence the timing of starting hormone therapy may matter _MNT_ had the opportunity to speak with [Jennifer Wong](https://www.memorialcare.org/providers/jennifer-l-wong), MD, a board-certified cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, about this study. Wong, who was not involved in the research, commented that these findings are encouraging and add to the growing evidence that the timing of hormone therapy may matter. “The study suggests that starting hormone therapy earlier in the menopausal transition may have cardiovascular benefits for certain women, although more research is needed to determine which patients are most likely to benefit,” Wong explained. “The hormonal changes of perimenopause and menopause can coincide with changes in several cardiovascular risk factors,” she added. “Frequent or severe vasomotor symptoms, such as hot flashes and night sweats, have been associated with a higher risk of future cardiovascular events and may also occur alongside an unfavorable metabolic profile, including higher blood pressure, abnormal cholesterol levels, and elevated [fasting glucose](https://www.medicalnewstoday.com/articles/317466) [blood sugar],” she continued. “Menopause itself is not a disease, but this stage of life can be an important time to pay closer attention to cardiovascular health and risk factors,” Wong pointed out. She said that women should not feel that they simply have to endure significant hot flashes or night sweats: > “These symptoms can substantially affect quality of life and may also be a marker of increased cardiovascular risk. Women experiencing frequent or severe vasomotor symptoms should talk with their healthcare professional about treatment options and their individual cardiovascular risk. Hormone therapy may be appropriate for some women but is not recommended for everyone, so the decision should be individualized.” ## Good confirmation of previous research findings _MNT_ also spoke with [Prudence Hall](https://www.drprudencehall.com/), MD, an OB/GYN in private practice in Santa Monica, CA, who likewise was not involved in this study. Hall commented she was happy to see further studies on HRT and especially this study including perimenopausal women, which frequently starts in our mid 30s to early 40s. “The reported decrease it has on cardiovascular disease has been in our literature for some time and this is a good confirmation and addition,” she added. When asked how hormone therapy might help lower heart disease risk, Hall said one of the reasons is that a type of estrogen called estradiol helps lower blood sugar and stress. “It is also anti-inflammatory and lowers the [LDL cholesterol](https://www.medicalnewstoday.com/articles/ldl-cholesterol), as well as the bad [APOBTrusted Source](https://www.ncbi.nlm.nih.gov/books/NBK538139/) and [Lp(a) LDLTrusted Source](https://www.ncbi.nlm.nih.gov/books/NBK570621/) subparticles, which increase plaque, which is responsible for heart disease,” she explained. > “These root core causes of chronic diseases like heart disease, high blood pressure, and [stroke](https://www.medicalnewstoday.com/articles/7624) all decrease, as well as [Alzheimer’s disease](https://www.medicalnewstoday.com/articles/159442), [diabetes](https://www.medicalnewstoday.com/articles/323627), many cancers, and all cause mortality. Unhealthy aging is greatly decreased, which is why I remain so very positive about treating menopause with bioidentical hormones and encouraging lifestyle interventions.” > – Prudence Hall, MD “Keep in mind that once a woman enters menopause, if left untreated, she remains in menopause for the rest of her life,” Hall added. “Therefore, the way we handle our menopause will determine the outcome of the next 40-50 years to create a life of radiant vitality or a life of continual decline.” Advertisement Explore these resources for heart health ![](https://healthline-activation-prod.healthline.com/driver-images/NoomOtherNutImageSquare.jpg) ![](https://healthline-activation-prod.healthline.com/driver-images/Noom%20Logo%20New%201.png) ![](https://media.post.rvohealth.io/2kLEJX4A3LDe7GGDNr31WST2A26/2026/03/19/3BAMgQ713YOQeHm635d1KtkTMrP.png) **Great for sustainable weight loss plans** * Prioritizes a balanced relationship with food * Uses a quiz to create a custom plan and estimated timeline * Now pairs GLP-1 treatments with psychological support * $209 per year with other plans available **21-Day Free Trial** [TAKE QUIZ](https://www.noom.com/?clid=be2d523a-8652-4d46-a782-e4dcfd874551&gid=&lang=en&route=affiliate-trial-npb&rvo_aff=1&rvo_brandid=c44997c5-d77b-4c9d-9cca-fdc4fc007b87&rvo_prodid=abd7ac71-cf1a-4339-8d41-f5357f4d5941&rvo_subid=TBD&sp=redventures&step=pros&trial_length=21&upv=3&utm_campaign=weight21daytrial&utm_content=native&utm_medium=partnerweb&utm_source=healthline&utm_term=&rvo_subid2=/articles/start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study-suggests&rvo_sys=mar) ![](https://media.post.rvohealth.io/2kLEJX4A3LDe7GGDNr31WST2A26/2026/04/09/3C7nhY8l6hfbVyFAy7Y7adsoZow.png) ![](https://media.post.rvohealth.io/2kLEJX4A3LDe7GGDNr31WST2A26/2026/04/17/3CUvfg5SdlPQCvArNccbpXVIpk3.png) ![](https://media.post.rvohealth.io/2kLEJX4A3LDe7GGDNr31WST2A26/2026/03/19/3BAMgQ713YOQeHm635d1KtkTMrP.png) **Access GLP-1s and personalized clinical care** * Online provider consultation and ongoing clinical care * Medication, shipping, and injection kit included * Transparent pricing with no insurance needed * Access GLP-1 Treatments 100% online [START NOW](https://hersinc.pxf.io/c/411371/2061414/23930?rvo_aff=1&rvo_brandid=Hers&rvo_prodid=69d5d2de-e794-4b3c-9e7e-957a1dbe4c51&rvo_subid=69d5d2de-e794-4b3c-9e7e-957a1dbe4c51&sharedid=CPA_&rvo_subid2=/articles/start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study-suggests&subid3=63e5022d-ec57-4e5f-8879-b0a6da047a39&subid2=/articles/start-menopausal-hormone-therapy-early-for-a-lower-heart-disease-risk-study-suggests&subid1=null) ![](https://healthline-activation-prod.healthline.com/driver-images/LifeLineImageTesting.png) ![](https://healthline-activation-prod.healthline.com/driver-images/lifelinescreening.png) ![](https://media.post.rvohealth.io/2kLEJX4A3LDe7GGDNr31WST2A26/2026/03/19/3BAMgQ713YOQeHm635d1KtkTMrP.png) **Get Screened for Peripheral Artery Disease** * Helps identify stroke and cardiovascular risks * Includes five screenings in just one visit * Only $159 for the complete 5-test package [F
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