HRT and Cancer
There has been a lot of debate about how HRT relates to breast and other cancers. If a woman uses HRT for more than five years, she seems to have a small but significantly higher risk of breast cancer. A 2001 study suggests that HRT increased the risk of death from ovarian cancer.
That study followed more than 211,000 women. They were divided into three groups:
- those who used HRT at the time of the study
- those who said they had used it in the past
- those who had never used it
Women who used HRT for more than 10 years had an increased risk of dying from ovarian cancer. The media reported that women who take HRT had twice the risk of ovarian cancer. The majority of women in the study, though, used “unopposed estrogen.” That means they used estrogen alone. They did not take progesterone. Women who use HRT today and still have their uterus almost always get a combination of the two.
The study doesn’t make clear whether women taking both would have a higher risk of ovarian cancer. Plus, an increased risk was only seen in women who had used HRT for more than 10 years. Many women take the drug for less time. Those who took it for less time in the study had no increased risk. There was also no significantly higher risk in women who had not taken estrogen in the 15 years before.
The risk of ovarian cancer death was higher for women who had used HRT. But it was still very small. For example, 26 out of 100,000 women who had never used HRT died of ovarian cancer. This can be compared to 64 out of 100,000 women who had taken HRT for 10 years or more. So, less than one out of every 1000 women—among users and never users—died of ovarian cancer.
The risk of breast or ovarian cancer needs to be compared to the health risks that come with menopause:
- One in three women will die of heart disease.
- Osteoporosis results in 1.3 million fractures each year.
- Each year, hip fractures claim the lives of more than 60,000 women.
- More than two-thirds of all menopausal women will experience symptoms that may have a major impact on their quality of life. For example, they will have hot flashes, night sweats, and sleep disturbance.
HRT has been shown to reduce risk for all these health problems.
Women and their doctors need to weigh the risks of using HRT against the risks of not using HRT. Each woman’s individual situation should be considered. That includes medical histories, lifestyle habits, and personal preferences. Only then can a woman decide whether HRT is right for her.