What A 12-Year Study Reveals About Hormone Therapy & Heart Disease Risk

For years, hormone therapy has been one of the most debated treatments in women’s health. Depending on when you started paying attention to the conversation, you may have heard that it’s one of the most effective ways to manage menopause symptoms, or that it comes with serious health risks.

Part of the confusion comes from how much our understanding of hormone therapy has changed over the past two decades. The treatments available today aren’t necessarily the same ones researchers studied years ago, and we’re learning that when women start treatment may matter just as much as which treatment they choose.

Now, a large new study is adding some reassuring evidence to the conversation.

Researchers followed more than 52,000 women for 12 years

In a new study being presented at the American Heart Association’s Scientific Sessions 2026, researchers wanted to better understand whether modern hormone therapy increases the risk of heart disease and other cardiovascular problems.

They looked at health records from 52,330 women between the ages of 45 and 59, none of whom had previously been diagnosed with heart disease, blood clots, or cancer. About half of the women had started hormone therapy, while the other half hadn’t.

Researchers made sure the two groups were similar in important ways, including age, weight, blood pressure, cholesterol, smoking habits, and diabetes history. They then tracked their health for an average of 12 years, looking at whether women experienced heart attacks, strokes, blood clots, or early death.

The study also included several types of hormone therapy, including pills, patches, and gels.

Hormone therapy wasn’t linked to a higher risk of heart disease or stroke

Here’s what researchers found: Women taking hormone therapy were no more likely to experience cardiovascular problems than women who weren’t taking it.

Over the study period, 4.4% of women using HRT experienced a cardiovascular event, compared with 4.6% of women who didn’t use it. The researchers also found:

• Blood clots: Both groups had the same rate, at 0.33%.

• Early death: Rates were nearly identical, at 1.3% among HRT users and 1.2% among nonusers.

• Different types of HRT: The findings were similar whether women used pills, patches, or gels.

These findings are particularly interesting because concerns about cardiovascular risks have shaped the hormone therapy conversation for decades. Much of that concern came from earlier studies that included older hormone formulations and women who started treatment well after menopause.

But researchers now understand that when a woman starts hormone therapy matters. For many otherwise healthy women, starting treatment before age 60 or within 10 years of menopause generally offers a more favorable balance of benefits and risks.

Of course, this study has its limitations. It was observational, meaning researchers looked at women’s health records rather than randomly assigning them to take HRT. That makes it difficult to rule out other factors, like diet, exercise, or differences in overall health. These findings still need to undergo peer review, but they add to our understanding of hormone therapy’s safety and why it deserves consideration as a treatment option for women navigating menopause.

RELATED READ: This Flawed Study Set Women’s Health Back By Decades (& You Probably Still Believe It)

What to consider if you’re thinking about hormone therapy

If you’ve been hesitant to consider HRT because of concerns about your heart, this research may offer some reassurance. But whether it’s right for you depends on your individual health history and symptoms.

A few things worth discussing with your doctor include:

• Your age and where you are in menopause: Starting HRT before age 60 or within 10 years of menopause is generally associated with a more favorable benefit-risk balance.

• Your health history: Factors like previous blood clots, heart disease, certain cancers, and cardiovascular risk factors can influence whether HRT is appropriate.

• The type of hormone therapy: Pills, patches, and gels aren’t necessarily interchangeable when it comes to individual risks. Your doctor can help determine which option makes the most sense.

• How much your symptoms are affecting you: If hot flashes, night sweats, or disrupted sleep are interfering with your daily life, it’s worth talking about treatment options.

The takeaway

One of the most important takeaways from this research is just how much our understanding of hormone therapy has evolved. What we know today looks quite different from what we knew 20 years ago, and women deserve to make treatment decisions based on the most current evidence.