A new study linking breast cancer and the use of hormone replacement therapy (HRT) is both concerning and comforting, but, without carefully studying the data it is not easy for most women (or their doctors ) to know what to make of this. Upon closer examination, however, the study actually helps clarify the controversial and sometimes contradictory issue what are the risks and benefits of HRT?
The Women's Health Initiative (WHI), launched in 1991, consisted of a series of clinical trials involving 160,000 healthy postmenopausal women.The study examined the effects of postmenopausal hormone therapy and dietary practices on heart disease, fractures, and breast and colorectal cancer. Both Premarin (estrogen) and Prempro (estrogen plus progestins) were studied.
But, in 2002, the Prempro arm of the study, which was scheduled to run until 2005, was abruptly halted when it was found that women taking the drug were more likely to have increases in heart disease, stroke, and pulmonary embolism than women taking placebo. No such effects were noted in the estrogen-only trials, which continued.
The current study has now found additional risks for women who took the combined hormone pill, Prempro. Their risk of breast cancer rose significantly as much as double, depending on the timing and duration of use of the drug.
While this may be disconcerting to women who took Prempro, or are currently taking HRT, it helps to clarify the issue not all hormones are created equal. The use of estrogen only, especially for short-term relief of post-menopausal symptoms (hot flashes) should not be confused with long-term use of Prempro.
ACSH s Dr. Gilbert Ross maintains that perspective must be rendered on this: HRT is still the best available treatment for women in peri-menopause and early menopause who suffer from intractable symptoms, including hot flashes, insomnia, poor concentration, vaginal dryness, and other symptoms of the severe menopausal state. But HRT should be used for the briefest interval required. Also, while the relative benefits of estrogen-only hormone therapy are valid, it should be emphasized that women who have their uterus those who have not had a hysterectomy cannot receive estrogen-only therapy due to the significantly increased risk of uterine hyperplasia and cancer.