Study Shows Hormone Therapy Is Linked to Autoimmune Disease

In a retrospective cohort study, the use of hormone therapy in postmenopausal women was associated with a significantly higher incidence and risk of autoimmune diseases. 

For the study, the researchers used data from the U.S. Collaborative Network within the TriNetX Global Health Research Network, which allowed for real-time access to de-identified patient data. Postmenopausal women were identified with ICD-10 codes indicating menopause. Women with records of estrogen use on or after menopause diagnosis were assigned to the hormone therapy cohort, and those without such records were assigned to the non-hormone therapy cohort. 

The research team used propensity score matching to balance baseline characteristics, such as age, ethnicity and comorbidities, including obesity, type 2 diabetes, essential hypertension and major depressive disorder. After matching, each cohort included 907,911 postmenopausal women. Mean age was 60.5, 77.6 percent were white, 7.6 percent were Black and about six percent were Hispanic or Latino.

When evaluating individual autoimmune conditions over the full postmenopausal period, there were statistically significant increases in risk for all conditions, except for Graves’ disease and autoimmune hepatitis. Risk ratios ranged from 1.03 for psoriasis to 2.90 for lichen sclerosus. The hazard of developing any autoimmune disease over the full period was higher among hormone therapy users.

“Hormone therapy remains a safe and important option for many women when used appropriately but, like any treatment, it should be individualized while we await more research on its possible links to autoimmune disease,” said Xuezhi (Daniel) Jiang, MD, PhD, of Drexel University College of Medicine in Philadelphia. “Because this was a retrospective database study, more research is needed before drawing firm conclusions.”