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Can Hormone Therapy Help Your Heart Health?

A new study found that women who started treatment during menopause or shortly after had a lower cardiovascular disease risk

4-minute read

Kristen Fischer,

AARP

Published November 06, 2026

A woman wearing red glasses and a red shirt holds a red bell pepper shaped like a heart against a bright pink background.

Study links hormone therapy to lower stroke and heart attack risk.

AARP (Getty Images)

Key takeaways

Women who use hormone therapy have a 22 percent lower risk of stroke and heart attack than those who don’t, and those who start within 10 years of menopause have a 27 percent lower cardiovascular risk.
The strongest benefit has been seen in Black women who begin hormone therapy within 10 years of menopause, who have a 49 percent lower risk of cardiovascular events compared to those not on it..
The findings don’t mean hormone therapy can prevent cardiovascular events.

Hormone therapy may do more than help tame hot flashes and night sweats. Research suggests it could come with heart benefits for women going through menopause.

A recent study published in JAMA Internal Medicine found that women who took hormone therapy had a 22 percent lower risk of stroke and heart attack compared with those who didn’t.

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The benefits were even more pronounced among women who started hormone therapy within 10 years of menopause: Their cardiovascular risk was 27 percent lower than women who started outside that window. The greatest protective effect, however, was seen in Black women, who had a 49 percent lower cardiovascular risk when they started hormone therapy in perimenopause or early menopause, which occurs before the age of 45.

The findings do not mean that menopausal hormone therapy should be prescribed to prevent cardiovascular disease, says Samar El Khoudary, a coauthor of the study and chair and professor of epidemiology in the School of Public Health at Virginia Commonwealth University in Richmond, Virginia. Rather, the results suggest that women with vasomotor symptoms, such as hot flashes, may see cardiovascular benefits when they begin hormone therapy during menopause, study coauthor Rebecca C. Thurston, of the University of Pittsburgh School of Medicine, explained in a news release.

A closer look at the study

The data came from 2,737 women enrolled in the Study of Women’s Health Across the Nation (SWAN) who reported vasomotor symptoms and had not previously experienced any cardiovascular events. Of them, 755 started hormone therapy. The average age of the study participants was 54.

For the study — which was observational, meaning it cannot establish cause and effect — researchers compared data from women on the therapy and those not on it and evaluated their cardiovascular outcomes.

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It’s important to note that the study’s findings reported on relative risk, not absolute risk. Relative risk compares the likelihood of an event between two groups — in this case, those in the study who took hormone therapy and those who didn’t. Absolute risk, on the other hand, is the actual chance you’ll experience an event over a given time period. In the real world, the absolute risk would translate to three fewer cases per 1,000 women at five years of follow-up after treatment. and nine fewer cases per 1,000 at 10 years.

“A 27 percent lower relative risk means that the risk in the hormone therapy initiators was 27 percent lower than in the comparison group. However, this does not mean that an individual woman’s absolute risk would decrease by 27 percentage points,” El Khoudary said.

El Khoudary says more research needs to be done to better understand the connection between hormone therapy and potential heart benefits.

One open question, for example, is whether the protective effect observed in the study was attributable to hormone therapy or to participants’ overall health, says Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine in Chicago, who was not involved in the study. Streicher says women who take hormone therapy tend to eat healthier, exercise and have other factors associated with a lower risk of cardiovascular events.

Heart disease and menopause

Cardiovascular disease is the leading cause of death among women, and research shows that a woman’s risk for it rises during menopause due to declining estrogen levels and other age-related and metabolic changes.

The timing of menopause can also influence the degree of cardiovascular risk.

Women who experience menopause before the age of 40 — what’s known as early menopause — have about a 40 percent higher risk of developing coronary heart disease compared with those who go into menopause later, according to a 2026 study published in JAMA Cardiology.

Interestingly, research has shown that starting menopausal hormone therapy after the age of 60, or starting it more than 10 years after menopause, may come with negative outcomes like stroke and blood clots, a 2026 report in European Heart Journal shows.

And it’s important to note that hot flashes — which affect approximately 75 percent of women in menopause — aren’t just bothersome. “They’re associated with cardiovascular damage,” Streicher says, though the connection isn’t entirely clear. Some research suggests that hot flashes interrupt sleep, which has been linked to heart disease. “Hot flashes are not harmless,” Streicher warns. Talk to your doctor about them.

If you have questions about the best time to start hormone therapy, or are worried that you didn’t start it early enough, you should also talk to your doctor, Streicher says.

Hormone therapy isn’t right for everyone, and treatment decisions should take into account your specific symptoms, risks and overall health. If hormone therapy isn’t right for you, there are nonhormonal options that can also help with hot flashes and night sweats. It’s unclear, however, whether these new medications have heart benefits.

Based on all the available evidence, Streicher notes, the most important thing women can do to prevent heart disease is to eat a healthy diet, exercise regularly and get adequate sleep.

The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.

Kristen Fischer is a contributing writer at AARP based at the Jersey Shore. She has also written for Health, WebMD, and McKnights and is the author of Zoo Zen: A Yoga Story for Kids.

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