Menopause

HRT benefits versus risks – an individual’s choice!

When I ask women about their main concern regarding using HRT, they invariably will say they worry about the risk of breast cancer. So, I feel it is really important for women to understand the true risks involved so they can make an informed choice. Studies have shown that for the majority of women, the breast cancer risk associated with HRT is very small – in fact, drinking a large glass of wine each evening increases your risk of developing breast cancer more than HRT does. There are even some forms of HRT that are actually associated with a lower overall risk of breast cancer.

It is also important to add that HRT has significant positive health benefits, particularly relating to your heart and bones. When all these factors are considered, the health gains to be had from taking HRT often far outweigh the potential risks.

What is important is that women receive individualised advice, taking into account their own circumstances. Doing this allows women to make a personalised risk and benefit assessment, so they can then choose if HRT is right for them.

3 Comments

  • Charlotte Cotton

    Thank you for your reply. I have booked a consultation and between now and then will try non hormonal options and try and get my GP to give me vaginal oestrogen so by then we know if they are helping. Ideally I would like to come off Tamoxifen for these last 7 months as I am done with the aches pains sweats and fog.

  • Charlotte Cotton

    I am 52 and coming to the end of 5 years on Tamoxifen for invasive lobular carcinoma ER positive breast cancer in 2017. Depleted oestrogen is taking its toll and I have many symptoms. I have read lots around the subject but can’t find any advice for taking transdermal oestrogen when I had that kind of cancer. I want to be armed with facts for upcoming GP visit. She has already advised me against any HRT. ….any advice/pointers would be really helpful. Thank you.

    • admin

      Thank you for your question. The use of HRT after a diagnosis of breast cancer is not clear cut. Unfortunately, the studies that were developed to look at the risk of breast cancer recurrence with HRT were prematurely halted because the data initially suggested a significant increased risk. However, reassessment of this data, and follow-up of some of the women more recently, suggests the risk is much lower, particularly with the more modern types of HRT we now use.
      Guidelines still state that a history of breast cancer should be viewed as a contraindication to HRT, but that the option of using HRT can be considered in women who have impaired quality of life due to menopausal symptoms, as long as they are provided with information about the known (and unknown) risk from the limited data available.

      One thing to point out, the use of vaginal oestrogen is considered to be a safe option in women with a history of breast cancer. There is good data to show that blood absorption of oestrogen is extremely low from vaginal products, and there is also data to show that vaginal oestrogen does not increase the risk of breast cancer recurrence.

      I would suggest speaking to your GP, or ideally your breast cancer team, to get advice on your options. There are also other non-hormonal options you can consider to help with symptoms too.

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