Hormonal Treatment May Delay Aging in Postmenopausal Women

Researchers examined the relationship between hormone therapy (HT) and the variation in the chronological and biological ages of postmenopausal women, divided by socioeconomic class (SES), in a new study that was published in JAMA Network Open. The mediating effects of the age disparity on the association were also investigated.

Context
Delaying aging and monitoring the pace of aging to account for population variation are key components of attempts to prevent diseases and improve health in the aging population. When it comes to forecasting negative consequences, the difference between chronological and biological age is more accurate than other aging metrics.

As HT provides estrogen, women’s health—a demographic that goes through menopause, a disorder linked to estrogen loss—is the main emphasis. Exogenous systemic estrogen is advised by doctors to treat menopausal vasomotor problems.

Concerns exist, nevertheless, about how HT may affect one’s health. According to the Women’s Health Initiative Hormone Trials, HT raised postmenopausal women’s risk of dementia and stroke.

The Nurses’ Health Study observational data indicated that HT might offer protection against significant coronary events. For present practice, HT’s health consequences must be determined.

About the Study

The current study assessed relationships between postmenopausal women’s hormone therapy, socioeconomic status, and variations in their chronological and biological ages. They also looked into whether the disparity acts as a mediating factor in the relationship between the risk of mortality and hormone treatment.

117,763 postmenopausal female individuals in the United Kingdom Biobank, aged 40 to 69, were included in the study. The subjects were polled by the researchers regarding their use of hormonal therapy and biological aging markers between March 2006 and October 2010.

The data was examined in December 2023. Digital questionnaires were utilized to gather relevant data regarding the use of hormonal therapy, the age at which treatment commenced, and the length of treatment.

Phenotypic age was used to assess the biological aging disparity, which was the main study outcome. Using the participants’ chronological ages and nine biomarkers that were extracted from their biological samples, the researchers used proportional hazard modeling to determine the biological age of each person. The difference between the biological and chronological ages was found using linear regressions.

The Townsend Deprivation Index, income, occupation, and education were examples of socioeconomic status indicators. Mortality data were provided by the National Health Service Central Register of Scotland and the National Health Service Information Centers of England and Wales. The cause of death was determined by the International Classification of Diseases, Tenth Revision (ICD-10) codes.

The hazard ratios (HR) were determined using Cox proportional hazard regressions, which also corrected for factors such as education, ethnicity, physical activity, exposure to nicotine and tobacco, hypertension, diabetes, chronic renal illness, bilateral oophorectomy, and hysterectomy.

The researchers classified users of hormone treatment into a single category and kept in place current HT users for sensitivity analyses. Those who had undergone a hysterectomy or bilateral oophorectomy, as well as those who finished the biological aging evaluation within a year following the survey, were not included.

They conducted segmented regression analysis using the restricted cubic spline approach, omitting women who were going through menopause before the age of 44.

In summary
The results of the study demonstrated that postmenopausal women who take hormonal therapy are younger than non-users, particularly those from lower socioeconomic backgrounds, either physiologically or phenotypically.

Hormonal therapy (HT) used for four to eight years is linked to 0.3 years of biological aging difference, which mediated 8.3% to 19% of the mortality-hormone treatment relationship.

Before the age of 48 and within 7.4 years, there was a stronger correlation between hormone treatment and a smaller aging disparity; however, the longer the duration of HT consumption, the stronger the inverse link. It may be essential for healthy aging for postmenopausal women to promote HT, while more studies are needed to assess the potential therapeutic advantages.

For more information: Hormone Therapy and Biological Aging in Postmenopausal Women, JAMA Network Open, doi:10.1001/jamanetworkopen.2024.30839.