Hormone Therapy Cardiovascular Risk Lower in SWAN Study

Hormone Therapy Cardiovascular Risk Was 22% Lower

Menopausal hormone therapy use was linked to a 22% lower risk of cardiovascular disease events among women with hot flashes or night sweats. The comparison was with women who had these symptoms but did not use hormone therapy.

Researchers from Virginia Commonwealth University and the University of Pittsburgh analyzed 20 years of health data from the Study of Women’s Health Across the Nation (SWAN). According to [Virginia Commonwealth University’s report](https://medicalxpress.com/news/2026-09-hormone-therapy-hot-night-menopausal.html), the findings were published September 8 in JAMA Internal Medicine.

The Findings Apply to Women With Menopause Symptoms

The study focused on women with vasomotor symptoms who used hormone therapy during perimenopause or early postmenopause. Vasomotor symptoms include hot flashes and night sweats.

The observed association was strongest among Black women and women who started therapy within 10 years of menopause onset. The source does not provide the number of participants or separate risk estimates for these groups.

Timing Shaped the Observed Cardiovascular Association

Starting hormone therapy closer to menopause was associated with lower cardiovascular risk in this study population. Senior researcher Samar R. El Khoudary said the timing of treatment initiation may influence cardiovascular outcomes.

The cardiovascular events examined included conditions such as stroke and heart failure. The findings apply to future event risk among women with menopause symptoms, rather than to women using hormone therapy specifically to prevent cardiovascular disease.

Hormone Therapy Cardiovascular Risk Has Important Caveats

The study was observational, so it cannot establish that hormone therapy caused the lower cardiovascular risk. It was not a randomized controlled trial, which researchers described as the preferred method for testing biomedical treatments.

The researchers said the results should not guide clinical practice or support hormone therapy for cardiovascular disease prevention. They also noted that treatment decisions must weigh possible benefits against risks, including the increased breast cancer risk observed with longer use.

Menopause Symptoms Provide the Treatment Context

Hot flashes and night sweats affect up to 80% of women during the menopause transition, according to the source. These symptoms last seven to 10 years on average and often peak during early postmenopause.

Hormone therapy replaces estrogen and progesterone that decline after menopause and is described in the source as the most effective treatment for these symptoms. The supplied report does not provide results for blood sugar, insulin resistance, hormone therapy formulations, doses, or treatment routes.

Clinical Decisions Require Individual Risk Review

The study adds information about cardiovascular outcomes among symptomatic women who begin hormone therapy near menopause. It does not determine whether treatment is appropriate for a particular person.

People weighing treatment can talk to a clinician about symptom severity, menopause timing, expected treatment duration, breast cancer risk, and hormone therapy cardiovascular risk.