Precision planning makes menopausal hormone therapy more effective and safer

Tomi Mikkola investigates the pros and cons of menopausal hormone therapy.

What are your research topics?

I investigate the health effects of menopausal hormone therapy, which is the only effective treatment for difficult menopausal symptoms. However, the treatment also has other health effects on, for example, the skeletal system, the memory and the heart. The most important of these is the effect of the treatment on the risk of cardiovascular diseases, which is the number one cause of morbidity and mortality among ageing women.

Where and how does the topic of your research have an impact?

Finnish women enter menopause on average at the age of 51, and a significant share of women need menopausal hormone therapy for hot flashes, sleep difficulties and other symptoms. Menopausal hormone therapy is based on the female sex hormone oestrogen, whose excretion from the ovaries protects fertile age women from heart diseases. When ovarian function cease, this protective effect is rapidly lost, making it tempting to replace the oestrogen with hormonal therapy. However, all drug therapies have both benefits and adverse effects. Their balance depends on individual risks and the way in which the therapy is implemented.

In the light of studies conducted in recent years, menopausal hormone therapy initiated in healthy women at the beginning of menopause reduces the risk of cardiovascular diseases. In contrast, a therapy initiated at a later stage may even increase the risk. We are now looking further into these connections and the underlying mechanisms. The goal is to provide optimal and safe care tailored to individuals.

What is particularly inspiring in your field right now?

Finnish women live up to more than half of their adulthood after menopause, and during that period they are active and at prime working age. It is great to be involved in advancing research related to the health of these women.