Modern menopause hormone therapy not linked to heart risk, Israeli study finds

A large Israeli study released by the American Heart Association on Monday, 2 November 2026, found that women aged 45 to 59 who started modern menopause hormone therapy did not have a higher risk of heart attack, stroke, blood clots or death over an average of 12 years than similar women who did not take it. The research, led by Ronen Arbel of Clalit Health Services in Israel, is being presented at the association's Scientific Sessions 2026. The association describes it as preliminary research that has not yet been published in a peer-reviewed journal.

For many women, the years around menopause bring hot flushes, night sweats, poor sleep and mood changes that can affect work, relationships and day-to-day wellbeing. Hormone replacement therapy, which replaces the oestrogen (and sometimes progesterone) the body makes less of after menopause, is one of the main treatments for these symptoms. Concerns about heart attack and stroke have long made some women and doctors cautious about it, which is why studies of its heart safety draw close attention.

This study adds a large, long-running piece of evidence to that debate. It looked specifically at women in the age group when most start treatment, between 45 and 59, who had no previous heart disease, blood clots or cancer, and followed them for an average of 12 years. In that group, the number of heart attacks, strokes and related heart problems was very close whether or not they took modern HRT, and so was the number of deaths before age 80.

The limits are important. The study is observational: it compares women who chose to start treatment with similar women who did not, so it cannot prove that the therapy itself caused or prevented anything, even after matching for many health factors. It covers only women without past heart disease, clots or cancer, so it says nothing about women at higher risk. And it has not yet been through peer review. The findings do not tell any individual woman whether to start or stop treatment; that remains a decision to make with a doctor who knows her medical history.

Peepals calculation: the HRT group had 72 fewer heart attacks, strokes and related heart events than the comparison group (2,383 − 2,311 = 72), about 3% fewer (2,311 ÷ 2,383 ≈ 0.97), while deaths before 80 differed by six (659 against 653). In groups of 26,165 women each, both gaps are small. Our calculation from the reported figures.

Short-term: The results are likely to be discussed by women weighing treatment for menopause symptoms and by the doctors who advise them, as one more piece of evidence on heart safety for women who start HRT between 45 and 59.

Long-term: If the findings hold up in peer review and in other studies, they could ease some of the fear that has kept women from considering hormone therapy, and shape how guidelines describe its heart risks for healthy women in midlife.

Who is affected: Women in perimenopause and menopause, especially those aged 45 to 59 without heart disease, blood clots or cancer; their doctors; and employers and health services that support women through menopause.

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