Understanding the Latest Research About Hormone Replacement Therapy

BlogHer Original Post

Field of WomenFor years there have been suspicions and studies linking Hormone Replacement Therapy (HRT) to breast cancer, but new research is now definitively linking HRT to an increase in breast cancer death rates.

It wasn't long ago that HRT was touted as a cure for menopause symptoms, that would also help your heart, your bones, and even prevent cancer.  From the East Hampton Star -- Menopause Matters:

In his 1966 best seller, “Feminine Forever,” Robert Wilson touted the virtue of using hormone replacement therapy and derisively referred to menopausal women as “flabby” and “shrunken.” It was recently revealed by the journal PLoS Medicine and The New York Times that virtually all popular writing supporting hormone replacement at that time was being secretly funded by Wyeth, the manufacturer of these same hormone replacement drugs.

As I discussed in my Jan. 21, 2010, column in The Star, “No Fountain of Youth,” hormone replacement therapy, also known as H.R.T., will quell hot flashes and preserve bone, but it does not prevent heart disease or cancer.

Yes, there really was a time (and not too long ago) that women were told HRT could prevent both heart disease and cancer.  We are now learning that that couldn't be further from the truth.  From CNN -- HRT Increases Breast Cancer Death Risk:

This latest research looks at 11 years of follow-up on the health of these women and the authors found that those who had used the therapy were not only more likely to develop but to die from breast cancer.

For decades women have been prescribed HRT – medications containing female hormones to replace the ones the body no longer produces after menopause. These drugs can be very effective at alleviating the hot flashes, night sweats and other discomforts of menopause. They have also been shown to help with bone health and may decrease the risk of colon cancer. But HRT, long heralded as being protective for heart health, has not lived up to its billing and women are now warned about the possible increase risk for heart attack and stroke. Last year a study found that combined HRT also increased a woman's risk of dying from lung cancer.

From the American Cancer Society -- Advanced Breast Cancers, Higher Death Rate Seen with HRT:

“It’s a very strong paper. It clearly takes advantage of a well-conducted clinical trial,” says Susan Gapstur, PhD, vice president of the American Cancer Society’s Epidemiology Research Program. “These findings are adding to the growing evidence and concern about long-term effects of estrogen plus progestin.”

The new research, based on data from 16,608 women, found that compared with patients on the placebo, those who took estrogen plus progestin (in a formulation known commercially as Prempro):

  • had a 25 percent higher risk of invasive breast cancers
  • were 78 percent more likely, if diagnosed with breast cancer, to have more advanced cancers, which had spread to the lymph nodes
  • faced about double the risk of dying of breast cancer, and for those with breast cancer, a higher risk of dying of any cause.

Here is a great (eight minute) video with one of the authors of this latest study discussing this research...

When I was looking for more information to include in this post, I came across a "real life" story that brings the scientific jargon and statistics to the level of you and me.  This is a sad, but in the end inspirational, story of Carol Saline (author of the book Sisters), who was affected by years of hormone replacement therapy.  This is a small excerpt from the article -- Becoming the Story:

Somehow, through all the years of my sister's ordeal, I'd held on to a wholly irrational conviction that I would never get breast cancer. Was I stupid, naïve or just fooling myself? While neither Patsy nor I carried the BRCA genetic mutation (the marker for inherited breast cancer) and none of the women in our family had had the disease, I'd chosen to play the odds and stayed on hormone replacement therapy for more than 20 years. Once, I'd tried to stop, but the hot flashes and the sleepless nights were intolerable. So I resumed, fully aware that HRT hormones increase the risk of breast cancer. In retrospect, that was probably a bad throw of the dice.

Do the benefits of hormone replacement therapy outweigh the risks?  It certainly doesn't seem so.  I think the important thing to remember about HRT is that often with trial and error, other much less risky options can be found to treat the hot flashes and symptoms associated with menopause. 

What do you think about this latest research on HRT?  Have you used hormone replacement medications?  Are there non-hormonal treatments that you have found helpful to treat these symptoms?  Tell us your story.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com

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