MOST ASKED QUESTIONS ABOUT HORMONE REPLACEMENT THERAPY

Will HRT Increase My Risk Of Cancer?

If one analyses all the published literature and clinical trials to date, it can be concluded that generally speaking death rates from all cancers are not increased by the correct use of HRT. However, very long-term studies are not available and it will be several decades before the real effect of natural HRT on the promotion or reduction of different cancers will be known.

Cancer of the Uterine Lining (Endometrium)
HRT reduces the risk of this cancer as well as ovarian cancer, perhaps by up to 40% compared to women not using HRT. This only applies if progesterone is given for at least 12 to 14 days of every monthly cycle.

Breast Cancer
Many women are reluctant to take HRT fearing that it will increase their chances of breast cancer. This remains a complicated and controversial issue especially as we are talking about the most common cancer in western women. Statistics show that breast cancer will affect one in every fifteen women by the age of 75 and one in eight women with a family history of this disease. Some of these cancers have oestrogen receptors and there is the possibility that these may be promoted by oestrogen therapy. Your risk of breast cancer peaks in your 50s and 60s and continues to rise progressively throughout life and so at this time one certainly does not want to take a substance that may further increase this risk. Risk factors for breast cancer include lack of childbirth, first childbirth after thirty, obesity, early puberty and a late menopause. A common feature in all these factors is prolonged and constant exposure to oestrogen from the ovaries. Women whose diets are high in fat and low in fibre have higher blood levels of oestrogen than women on low-fat, high-fibre diets. Women on high-fat, low-fibre diets have a much higher incidence of breast cancer and so it seems that we have yet another possible link between oestrogen and breast cancer.
Notwithstanding these theoretical considerations, of nearly 30 studies examining the relationship between oestrogen replacement and breast cancer, the majority have failed to indicate a definitive for or against8. Individually, these studies have found either a small decrease or small increase in the future incidence of breast cancer in users of HRT. A widely publicised 1989 Swedish study linked oestrogen with a slightly increased risk of breast cancer after six or more years of use. However, their conclusions were premature as they only followed up these women for an average duration of 5.7 years, when it is known that most breast cancers take seven years to grow large enough for detection. The same Swedish group found that when women using oestrogen did develop breast cancer, their survival rate was significantly better than that of women not on oestrogen.
A very useful overview of 23 studies suggested that HRT does not increase or decrease breast cancer.
As far as progesterone is concerned we have insufficient data to suggest that it offers any protection against breast cancer in women on oestrogen therapy.

Skin Cancer
Studies suggest that the use of oestrogen has no adverse effect on the subsequent development of malignant melanoma or other skin cancers.
In summary — it does not appear that properly balanced, natural HRT encourages the development of cancer and any slight increase in the death rate from cancer would be very small indeed compared to the drastic reduction in the death rate from osteoporosis, heart disease and stroke in oestrogen users.
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