Postmenopausal Hormone Therapy and Autoimmune Disease: What the Latest Research Shows
A large new study has explored the link between postmenopausal hormone replacement therapy (HRT) and autoimmune diseases, offering important insights for women navigating menopause. Researchers analysed health records from nearly 1.8 million postmenopausal women and found that those using hormone therapy had a higher risk of developing autoimmune conditions compared with non-users.
Over a 10-year period, HRT users experienced a 28% higher risk of autoimmune disease, with elevated rates seen across most conditions studied—including rheumatoid arthritis, lupus, psoriasis, and Sjogren’s syndrome—though Graves’ disease and autoimmune hepatitis did not show a significant increase. The absolute increase in risk, however, was relatively small, highlighting the importance of context when interpreting these findings.
The study used robust matching techniques to compare women on HRT with those who were not, controlling for factors such as age, ethnicity, obesity, type 2 diabetes, hypertension, and depression. Researchers emphasise that, while the study found a statistical association, it cannot prove causation, and more prospective research is needed to clarify how hormone therapy may influence autoimmune disease risk.
Experts agree that hormone therapy remains a safe and effective option for many women, particularly for managing menopausal symptoms, but it should always be prescribed in an individualised, risk-aware approach.
What does this mean?
It’s important to understand that these findings do not mean women should stop hormone therapy. Autoimmune diseases are far more common in women overall, and stress is a known factor in their development. In fact, women experiencing the most severe menopause symptoms—and who may therefore be more likely to use HRT—may also be under greater physiological and psychological stress, which could confound these associations (Paper 1, Paper 2).
Whether a woman chooses HRT or not, lifestyle and personalised interventions during menopause are critical. Supporting stress management, sleep, nutrition, physical activity, and metabolic health can reduce autoimmune risk and improve overall wellbeing.
How we approach this at Mosaic Medical
At Mosaic, our approach is fully personalised and takes time to get right. We combine:
- Comprehensive hormone testing, including Dutch tests and blood panels, to understand individual hormone patterns.
- Metabolic and lifestyle assessments, including nutrition, exercise, sleep, and stress levels.
- Continuous glucose monitoring where appropriate, to optimise metabolic health.
- Tailored lifestyle and nutrition plans, supporting immune resilience and overall wellbeing.
This holistic, data-driven approach allows us to support each woman’s menopause journey safely and effectively, recognising that optimal health isn’t achieved with a single intervention but through sustained, personalised care.