A recent study has found that women who start hormone therapy during perimenopause may age more slowly than women who do not take hormone therapy. The study, which involved 117,763 postmenopausal women, shows: Hormone therapy can aging process slow down — especially for women with low socio-economic status. The study also shows that hormone treatment can help reduce some of the biological effects of aging and appears to be particularly effective when started at the end of 40's.

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Hormone Therapy and Aging

The study found that 40.3% of women who had undergone hormone therapy at some point in their lives aged less quickly than women who had not undergone hormone therapy. The greatest benefit was seen in women who started hormone treatment at 48.4 years of age and continued it for four to eight years. Women with low socio-economic backgrounds benefited in particular — for them, hormone treatment offset the disadvantages of aging.

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Interestingly, the research found that women from higher income groups aged more slowly overall, regardless of whether they had received hormone treatment or not. This suggests that although hormone therapy may be of great benefit to some women, factors such as social status also play a role in the aging process.

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Chronological Age vs. Phenotypic Age

Phenotypic aging describes the visible and measurable changes that the body experiences over the course of life. It includes external features such as wrinkles, gray hair, and skin changes, but also internal processes such as the decrease in muscle mass, the decrease in bone density and changes in Organ functions. Phenotypic aging is influenced by a combination of genetic factors, environmental conditions and lifestyle and manifests itself differently from person to person, such as differences in health and fitness between people of the same age.

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The study assessed participants' aging from the point of view of phenotypic aging because, according to the study's lead author, this is a biological measure that reflects the actual age of a person's body based on various health characteristics.

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“Chronological age is simply the number of years you live, but phenotypic age goes deeper into biological markers to measure how fast you age.”

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By analyzing the difference between a woman's chronological and phenotypic age, researchers were able to determine the impact of hormone replacement therapy on slowing the biological aging process.

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Perimenopause — The Best Time for Hormone Therapy

The study underscores that perimenopause — the transition period before menopause — appears to be the optimal time to start hormone therapy. The World Health Organization (WHO) defines perimenopause as the years before the end of the menstrual cycle and oocyte exhaustion. In this phase, the hormone levels to fluctuate, leading to symptoms such as hot flashes, sleep disorders, and mood swings that can be alleviated by hormone treatment.

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The study also suggests that hormone treatment during this phase not only alleviates menopausal symptoms but may also slow down the body's biological aging process.

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Hormone Therapy Controversy

Hormone therapy has been the subject of controversy among experts for decades. First concerns were raised in the early 1990s when the Women's Health Initiative (WHI) study suggested that hormone treatment in postmenopausal women was at risk of dementia and could increase stroke without providing the expected cardiovascular benefits. Around the same time, the Nurses Health Study presented conflicting results that suggested that hormone replacement therapy could reduce the risk of dementia.

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In recent years, experts have reassessed previous studies, and the consensus has shifted. An important finding from the new evaluations is that the time at which hormone therapy starts plays a decisive role in its effect. Most participants in the WHI study were over 62 years old, i.e. at an age when many no longer have estrogen receptors and some had already developed diseases such as arteriosclerosis. In contrast, hormone treatment appears to have the most benefit when started earlier, during perimenopause or shortly after.

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Even though hormone therapy may still be associated with risks, particularly for older women, the results of the study confirm that starting hormone therapy during perimenopause can not only alleviate menopausal symptoms, but also slow down the biological aging process.

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The new research findings underline how important the right time is for hormone therapy. For women approaching menopause, starting hormone treatment during perimenopause could help slow phenotypic aging, particularly among women from lower socio-economic classes who would otherwise age more quickly. However, women considering hormone therapy should seek advice from their doctor or health care provider to weigh the potential benefits and risks based on their individual health profile and the appropriate time.

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This study brings new clarity to the long-standing debate about hormone therapy and offers a promising perspective on how it can contribute to healthier aging for women.