Taking hormone replacement therapy (HRT) appears to slow biological aging, according to a new study by Chinese researchers that included more than 100,000 women participants from the UK Biobank. The study found that postmenopausal women with historical hormone therapy (HT) use were biologically younger than those not receiving the treatment. The beneficial effect was strongest in those with low socioeconomic status (SES).
The researchers write “These findings support HT use in postmenopausal women to promote healthy aging and address related health inequalities.”
Their study was published last week in JAMA Network Open. The lead author is Yufan Liu of Capital Medical University, Beijing, China.
During menopause estrogen production by the ovaries is reduced. HT has been long used to treat menopausal disorders. But there is conflicting evidence about the various benefits versus harms of the therapy. For example, two large-scale, observational studies recently found that hormone therapy use was associated with an elevated incidence of dementia and stroke. Other studies, however, say it improves cardiovascular health and other health outcomes. Many of these studies have been contradictory however. These researchers suggest the reason may be factors such as, “ healthy user bias inherited by observational studies and the heterogeneous timing of initiating HT, the latter of which was supported by an emulated target trial.”
In this study, biological aging was measured using “validated phenotypic age,” which was calculated using chronological age and nine biomarkers measured at baseline. All-cause and cause-specific mortality were also assessed.
The researchers note, “Several alternative measures have been developed to measure the aging process. Among these established measures, biological age assessed using phenotypic age is widely used. The phenotypic age is derived using a machine learning approach, capable of capturing morbidity and mortality risks across diverse populations, independent of chronological age.”
Among 117, 763 postmenopausal women, HT use was significantly associated with a smaller aging discrepancy in postmenopausal women with different SESs, with a stronger association in women with low SES, with a significant interaction observed for education.
The researchers write, “Because the discrepancy between phenotypic and chronological age is superior to other aging measures (including telomere length) in predicting adverse outcomes, examining its association with HT use could offer meaningful insight into promoting health and preventing disease.”
They add, “However, no study has examined the timing of HT with biological aging. Therefore, this study aimed to investigate the associations between HT use, including the timing of initiating HT; phenotypic age discrepancy in postmenopausal women; and the potential modifying role of socioeconomic status (SES).”
