Autoimmune Disease Risks Linked to Hormone Therapy Treatment: Study

The findings add to long-running concerns that hormone replacement therapy significantly increases the risk of breast cancer.

Researchers from Drexel University warn that postmenopausal women who use hormone therapy face an increased risk of developing different types of autoimmune conditions, which could have significant physical side effects, psychological and social impacts.

Hormone Replacement Therapy (HRT) includes a wide variety of treatments commonly used to restore hormone levels that naturally decline during perimenopause and postmenopause. It typically involves estrogen, progesterone, or a combination of both, and can be delivered through pills, patches, creams, or sprays.

According to new research presented at the Menopause Society annual meeting held on October 21 through 25 in Orlando, Florida, women receiving hormone replacement therapy faced a 33% overall increased risk of developing any type of autoimmune disease, which can affect nearly any part of the body.

HRT Health Concerns

Research has been mixed on the risks HRT may pose to women taking additional hormones. While most data indicates it may be beneficial when started within 10 years of menopause, other research warns of some risks.

Data published in 2020 by researchers from the U.K. suggests combined HRT treatments, treatment of both estrogen and progesterone, increased a person’s risk of breast cancer by up to 88% depending on the product.

A Danish study indicated HRT was linked to an increased risk of developing tumors, with women taking progestin-only HRT having a higher risk of developing two types of brain tumors.

In the new study, Dr. Xuezhi Jiang and colleagues analyzed data from 1.8 million women using the U.S. Collaborative Network within the TriNetX Global Health Research Network. They compared women who used estrogen after being diagnosed with menopause to those who did not receive hormone replacement therapy. The researchers did not specify which type of estrogen product was used.

Overall, the researchers found that postmenopausal women using HRT had a higher risk of developing autoimmune conditions. Five years after beginning use, they had a 29% higher risk of having an autoimmune condition compared to nonusers. By 10 years, the risk was 28% higher, and by 20 years, the risk was 27% higher.

The risk for each specific autoimmune condition varied, with the exception of Grave’s disease and autoimmune hepatitis. Rates for those conditions did not increase.

The study found a 3% higher risk of psoriasis and a 190% higher risk of lichen sclerosus among women using HRT. However, the overall increase in autoimmune disease risk remained small.

Researchers acknowledged that several other factors linked to autoimmune conditions, such as low vitamin D levels, stress, depression, poor sleep, smoking, obesity and high blood pressure, were not included in their analysis.

Since autoimmune diseases are more common in women, particularly after menopause, the findings suggest that hormones may influence immune function. Still, the researchers emphasized that further studies are needed.

They concluded that doctors should take an individualized approach when prescribing HRT, as it remains a common treatment for managing menopausal symptoms.

“Hormone therapy remains a safe and important option for many women when used appropriately but, like any treatment, it should be individualized while we await more research on its possible links to autoimmune disease.”

– Dr. Xuezhi Jiang, Drexel University

The study was presented at the Menopause Society annual meeting earlier this month. The findings are considered preliminary until published in a peer-reviewed journal.

Sign up for more health and legal news that could affect you or your family.