Stroke risk could be higher for women not on HRT: study

Women who don’t use hormone replacement therapy or go into early menopause could have a higher risk of stroke.

A new study published in the journal Neurology, the medical journal of the American Academy of Neurology, found that those with higher estrogen exposure throughout their life may have a lower risk of stroke.

Scientists used data from 122,939 postmenopausal women living in China with an average age of 58, which included information about their lifestyle, reproductive health information, estrogen levels, number of pregnancies and oral contraceptive use.

They used health insurance and disease registry data to conclude that 15,139 participants had a stroke in the following decade. 

Participants were divided into different groups based on reproductive life span — the number of years from first menstruation to menopause — which ranged from 31 to 36 years.

After adjusting for other stroke-inducing factors — such as age, smoking, physical activity and high blood pressure — the researchers found that those in the group with the longest reproductive life span had a 5% lower risk of all kinds of stroke.

When compared to those in the shortest group, the number rose to 15% with intracerebral hemorrhage — bleeding on the brain.

People with longer reproductive lifespans and who used contraceptives or HRT had fewer strokes by the time they reached their mid-60s. Higher estrogen levels also led to a lower risk of stroke.

“These findings might help with new ideas for stroke prevention, such as considering screenings for people who have a short lifetime exposure to estrogen,” lead author Peige Song, of Zhejiang University in Hangzhou, said.

Researchers said the results suggest that people who are at higher risk due to early menopause should be getting more regular blood pressure and cholesterol checks. 

“Estrogen exposure throughout life could potentially be a useful indicator of a person’s risk of different types of stroke following menopause,” Song said. “However, more research is needed on the biological, behavioral, and social factors that may contribute to the link between estrogen exposure and stroke risk across a woman’s lifespan.”