Estrogen replacement therapy that is not paired with progesterone increases the risk of stroke and heart attack.
"There is data that shows uh and I've read this that um like estrogen replacement therapy um that's not paired with progesterone could increase your risk of stroke and heart attack." (said at 0:53:33)
Progestogen is added to estrogen therapy exclusively to prevent endometrial hyperplasia and uterine cancer in women with an intact uterus, not to mitigate cardiovascular risks. Large randomized controlled trial evidence from the Women's Health Initiative (WHI) shows that oral estrogen-alone therapy does increase the risk of ischemic stroke (similar to combined therapy), but it does not increase the risk of coronary heart disease or heart attack (hazard ratio 0.94, 95% CI 0.78–1.14). In fact, adding a progestin (combined hormone therapy) was associated with an early elevation in coronary heart disease risk, rather than offering protection against heart attacks.
- contradicts: Menopausal hormone therapy and health outcomes during the intervention and extended postst… (JAMA 2013)
"The risks and benefits were more balanced during the CEE alone intervention with 204 CHD cases for CEE alone vs 222 cases for placebo (HR, 0.94; 95% CI, 0.78-1.14) and 104 vs 135, respectively, for invasive breast cancer (HR, 0.79; 95% CI, 0.61-1.02)" (abstract, results, passage verified)
pubmedfull study (doi) - context: Postmenopausal hormone therapy and the risks of coronary heart disease, breast cancer, and… (Seminars in reproductive medicine 2014)
"Specifically, with combined estrogen plus progestin, CHD risk was elevated early with the elevation dissipating after a few years of treatment... Stroke effects, on the contrary, did not seem to vary appreciably with these timing issues. The adverse effect was evidently localized to ischemic strokes, for which there was an approximate 50% increase with either regimen." (abstract)
pubmedfull study (doi)