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 FAQs A-Fib Drug Therapy: HRT

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

22. Do you have information about Hormone Replacement Therapy (HRT) and if it might help or hinder my atrial fibrillation?”

Intuitively one would expect that, if properly administered, HRT would have good effects like decreasing menopause symptoms, improving bone density, improving cardiovascular health, etc. HRT might reduce the risk of A-Fib by improving a woman’s overall health. But research on this topic isn’t all that clear. I found two contradictory studies.

Danish Study 2012: I found one Danish observational research study that HRT was associated with a decreased risk on new-onset A-Fib in women who had had a heart attack. They looked at 32,925 women and followed them for a year after discharge from the hospital after a heart attack. New onset A-Fib was diagnosed in 1,381 women (4.2%). But A-Fib rates decreased significantly if the women were on HRT (37.4 incidence rate vs. 53.7 for no HRT use).

Womens Health Initiative Study: Another observational study found a “modest” link of HRT to Atrial Fibrillation. These results were somewhat unusual in that women [with a hysterectomy] taking estrogen alone had a higher rate of A-Fib. But women with an intact uterus taking estrogen plus medroxyprogesterone didn’t have a significantly higher rate of A-Fib.

The lead author, Dr. Marco V. Perez, described how anecdotally women say that at certain times-during a period, pregnancy, or menopause-their arrhythmias can flare up. Hormones may play a role in A-Fib in women. Dr. Perez said he would now add A-Fib to the list of risks associated with taking HRT.

Takeaway: These two studies obviously contradict each other. But the results in the Dr. Perez WHI research were so “modest” and even contradictory that, when making decisions about HRT, we should probably favor the Danish study. However, much more research needs to be done in this area. If properly administered HRT improves your overall health, that might decrease your risk of developing A-Fib.

(I am way out of my comfort zone discussing womens’ health and HRT and would welcome comments from women or from anyone with insights about this topic.)

References for this article

Last updated: Monday, September 28, 2015

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