A Mother and her Two Daughters

20 October 2010

Hormones, Menopause & Breast Cancer

For decades women have been prescribed hormone replacement therapy (HRT) to compensate for the ones no longer produced after a hysterectomy or menopause. These drugs were developed to alleviate the onslaught of hot flashes, night sweats and other discomforts of menopause, and to generally help women remain “more youthful” – whatever that means. 

But in 2002, the federally funded Women’s Health Initiative revealed that the benefits of HRT were far outweighed by the increased risk of heart disease, stroke and breast cancer. 

It’s interesting to note that prior to the release of that study, more than 110 million HRT prescriptions were filled in the US.  By 2009, the number had plummeted by more than half, with only 40 million HRT prescriptions filled.  But what’s even more revealing is that between 2002 and 2009, breast cancer diagnoses finally began to drop, explaining why the number of breast cancer cases rose steadily for decades.  Hormone use, along with better detection procedures, obviously played a key role. 

In 2009, additional research revealed that women who took hormones were 70 percent more likely to die from lung cancer. 

A study published in today’s issue of the Journal of the American Medical Association confirms that postmenopausal women who take combined HRT (estrogen plus progestin) are at an increased risk of dying from breast cancer. 

The study of more than 12,000 women who were followed for about 11 years produced powerful evidence that deaths from breast cancer were more common among hormone-users.  The research found that women who took the combination of estrogen and progestin were more likely to have tumors that appeared to be larger, were often hard to treat and were more likely to have spread to their lymph nodes. But most important, their risk of death appeared elevated, with the research finding that hormone use appeared to double the relative risk of dying from breast cancer. 

Quoting from Dr. Hugh Taylor, chief of reproductive endocrinology at Yale University: 
"This really is a paradigm shift.  There was a whole group of people, including myself, who had been thinking hormone use was associated with an increased detection of breast cancer but not necessarily an increase risk of death from breast cancer. But this really nails it."

As they say, hindsight is 20/20.  I took hormone replacement therapy from 2000, the time of my hysterectomy, until the day I was diagnosed with breast cancer.  I can tell you this – I would much prefer hot flashes and night sweats to breast cancer, especially an aggressive breast cancer that also invaded my lymph nodes.  

Are you taking hormone replacement therapy?  If so, you should know that medical experts recommend that if women choose HRT, they take the lowest dose for the shortest duration – two to five years. Talk with your doctor about the new research findings, what is right for you, and ask for more information about alternative therapies that can help alleviate menopausal symptoms.  This is YOUR body!  Take control! 

Later this year, the Women’s Health Initiative will release additional results of the estrogen-only study (no progestin).  Estrogen only therapy is the preferred HRT treatment for women who, because of a hysterectomy, no longer have a uterus.

I wish I knew then what I know today.  

1 comment:

  1. I've read that bio-identical hormone replacement has been shown to be safer in studies in Europe. I've been using the creme combo for a couple of years. I used Premarin before I learned the difference. Any thoughts on the subject? I'd like to know what kind people were using who were diagnosed with breast cancer.


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