Hormonal health
Hormone therapy heart-safe for under 60s with menopause symptoms
Hormone therapy is safe for treating menopause symptoms such as hot flushes and night sweats in women aged 50–59, but should not be started after 70 due to cardiovascular risks, research shows.
The study analysed 20 years of data from over 27,000 women aged 50–79 with moderate to severe menopausal symptoms who received either treatment or placebo.
Women who began therapy between 50 and 59 showed no higher risk of heart disease compared with placebo.
In contrast, those over 70 faced substantially increased risk of atherosclerotic cardiovascular disease – a build-up of plaque in arteries that can lead to heart attacks and strokes.
Co-author JoAnn Manson is chief of the division of preventive medicine at Brigham and Women’s Hospital.
She said: “This paper has a very important message for clinicians and women considering HT use: HT is appropriate and has a favourable benefit: risk profile for treating hot flushes among women below age 60, but it’s important to avoid starting treatment after age 70 among women with hot flushes.
“Our findings support current HT guidelines but help to clarify that risk varies strongly by age.”
Researchers at Brigham and Women’s Hospital examined data from the Women’s Health Initiative trials, addressing long-standing fears about hormone therapy and heart safety.
The study is the first to look closely at links between hot flushes, hormone treatment and cardiovascular risk across different age groups.
Many women have avoided hormone therapy – used to ease hot flushes, night sweats and other symptoms – since earlier studies raised concerns about heart disease.
The new analysis showed clear age-related differences. Women starting treatment in their 50s had no added heart risks, while those beginning after 70 faced substantially higher danger.
Manson, a founding member of the Mass General Brigham healthcare system, is one of the principal investigators of the Women’s Health Initiative.
The findings offer guidance for treatment decisions during menopause, when falling oestrogen levels cause symptoms that can disrupt daily life. Hormone therapy replaces these hormones to reduce symptoms.
The heart safety profile differs sharply by age.
For women in their 50s, therapy carries no extra cardiovascular risk while easing symptoms. But beginning after 70 brings substantial risks, particularly of atherosclerotic disease.
The results support current clinical guidelines while adding clearer, age-specific evidence to help women and doctors make informed choices based on individual risk.
The distinction between age groups is key for treatment planning, offering reassurance to younger women considering therapy while warning against late initiation in older age.
Hormonal health
Study reveals why women more likely to get severe long Covid
Opinion
Swimming, periods and finding freedom in my body
By WUKA sports ambassador, Hannah Miley MBE 3x Olympian & Commonwealth champion
I started swimming when I was really young, I just loved being in the water.
The pool quickly became my second home, the place where I felt most like myself. I wasn’t a natural swimmer, but I loved to work hard, and racing gave me that outlet for my competitive side.
There was something about the rhythm of the strokes, the smell of chlorine, and the quiet hum beneath the surface that made me feel free.
I got my first period around age 12, and it was daunting. My body was changing, and I didn’t know what that meant for my swimming.
Wearing a swimsuit every day made me feel exposed, and I just assumed everything I was going through (heavy bleeding that lasted up to two weeks, cramps so bad they left me doubled over) was normal.
There were moments that really knocked my confidence: not realising my tampon string was visible, or climbing out of the pool to find blood running down my leg.
At competitions, I’d sometimes sit on my towel because I’d leaked through.
The heavy bleeding left me anaemic and constantly tired, but I kept pushing through. I wanted to swim at the highest level I could even if it meant battling my body every month.
Competitions & The Pill
I’ll never forget the 2004 Commonwealth Youth Games. My period started mid-competition, and during one race, the cramps hit hard.
Swimming through that pain was frustrating, all that training felt wasted. When I saw my GP back home, I was told the best way to “fix my period problems” was to go on the pill.
Those two words, fix and problems, shaped how I thought about my body for years.
At first, the pill seemed like the perfect solution. No more painful, unpredictable periods! I ran packets back to back to skip bleeds during competitions, thinking I was being smart.
What I didn’t realise was that the seven day break wasn’t a real period at all, it was a withdrawal bleed. I thought I was in control of my cycle, but I was actually masking it.
I didn’t understand how important my hormones were for health, recovery, and performance.
On the surface, everything looked fine. Beneath that, I was struggling. Under-fuelling, getting ill before big meets, and picking up constant shoulder and knee niggles.
But I didn’t connect any of it to my hormonal health. The pill blurred the picture, and for years, I lived in fear of my period returning at the “wrong” time.
Nothing compares to the emotion you feel when you make an Olympic team.

When I realised I had qualified for my first Olympics in 2008, it was surreal the culmination of years of early mornings, long sessions, and relentless dedication.
Standing on the pool deck with “Team GB” on my kit felt like stepping into a dream that little Hannah could only have imagined.
Racing around the world, representing Scotland and Team GB, was the greatest honour of my career.
Each competition taught me more about resilience, discipline, and the incredible things the human body can do when you push it to its limits.
I went on to swim at three Olympic Games, and while each one was different, they all shaped me not just as an athlete, but as a person learning to listen to and respect her body.
It wasn’t until 2020, during lockdown, that I finally came off the pill after more than 15 years. I was speaking to Dr Georgie Bruinvels when she asked a simple but powerful question:
“When was the last time you actually had a period?”
That question stopped me in my tracks. The answer? Not since before I started the pill as a teenager, over 15 years ago.
I learned that I should have taken longer breaks to let my hormones reset after five years.
It was probably mentioned when I first started but at 15 the chances of me remembering were going to be slim. I wished someone had reminded me.
For the first time, I began tuning into my body, tracking my cycle, adjusting my nutrition, and paying attention to the signals I’d ignored for so long. The difference was incredible.
My periods now last about five days, my cramps are mild and manageable, and I finally feel in sync with my body instead of fighting against it. And no little pill to remember to take each day.
The knowledge I have now would’ve been game changing for me as a young athlete.
Finding Freedom Again — This Time, on My Period
WUKA Sports Ambassador
Becoming a WUKA Sports Brand Ambassador felt like everything coming full circle.
To work with a company whose values aligned with my mission, supporting and empowering female athletes was incredible.
As an athlete, I only ever used tampons because I thought that was my only option.
But discovering products like period underwear and period swimwear has completely changed how I feel about my body and my period.

The first time I tried WUKA period pants, I couldn’t believe how comfortable they were. No rustling, no movement, and no fear of leaks. I actually forgot I was wearing them!
And their period swimwear? Game changer. No more worrying about climbing out of the pool and noticing blood running down my leg just confidence and freedom.
I can’t help but think how different my experience as a teenager could have been if products like this had existed then.
They would’ve given me comfort, reassurance, and a sense that my period wasn’t something to hide or fear.
That’s why I’m so passionate about opening up conversations around periods in sport.
For so many young athletes, missing training isn’t an option, but competing while bleeding can be stressful and distracting.
Period-proof swimwear can take away that anxiety — letting you focus on your performance, not your period.
What I’ve Learned
My journey has taught me that periods aren’t a “problem” to be fixed, they’re a natural, powerful part of who we are.
With the right knowledge, support, and tools, we can work with our bodies, not against them.
Period proof swimwear might seem like a small thing, but for a young swimmer, it can mean the world. It can mean the difference between fear and freedom, between shame and Confidence.
Periods are not the enemy of performance.
Ignoring them is.
Find out more about Wuka at wuka.co.uk
Features
Half of countries lack endometriosis care policies
Nearly half of countries lack national policies or clinical guidance for endometriosis care, a new global review has revealed.
Endometriosis affects about one in ten women and girls worldwide. Across 194 WHO member states, researchers found striking disparities in care.
More than a quarter of countries have no publicly available clinical recommendations, and only 7 per cent have government-endorsed care guidelines.
In many places, the only guidance comes from informal sources such as advocacy sites or social media, leading to inconsistent care.
Europe had the widest guideline availability, while many low- and middle-income countries had little or none.
Devon Evans, assistant professor at the University of Manitoba, said: “Our findings show that many people living with this chronic condition are navigating care in regions where no official recommendations exist.”
A companion analysis reported that half of all countries had no policy information available.
Ninety-six countries recognised endometriosis as a national problem, 48 put it on the political agenda, and 12 adopted policies for a national strategy.
Notable examples include national action plans in Australia and France that are being implemented and evaluated.
Tatjana Gibbons if from the University of Oxford’s Nuffield Department of Women’s & Reproductive Health.
Gibbons: “Despite increasing awareness of endometriosis, addressing the challenges faced by those living with the condition requires coordinated national strategies developed in collaboration with policymakers, advocates and patients themselves, to reduce its global burden.”
The authors called for governments, medical societies and patient groups to collaborate on clear, region-specific care standards to cut diagnostic delays, improve quality of life and ensure equitable access to treatment.
An accompanying editorial urged a shift “from awareness to action”, with WHO noting the condition’s physical, mental and socioeconomic impact and the need to demonstrate that policies and guidelines translate into real-world improvements.
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