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How Risky Are Hormones?

There's important new research out today about hormone replacement therapy and breast cancer. A new analysis of the landmark Women's Health Initiative has shown just how much of a risk women face from taking estrogen and progestin to relieve hot flashes and other problems due to menopause, and how quickly that risk goes away after they stop.

When the study originally came out in 2002, the results shocked the medical world and millions of women. For years they had believed that taking hormones would reduce the risk for heart attacks and have other health benefits. The study showed that not only did the hormones not protect the heart but they also increased the risk for breast cancer and other health problems. Millions of women stopped taking the hormone therapy, and the findings have been the subject of intense debate.

In the new analysis, published in today's issue of The New England Journal of Medicine, Rowan Chlebowski of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in California and colleagues researchers analyzed data from more than 15,000 in the original study and another 41,448 women in a separate, related study.

The researchers found that if women took the hormones for five years, their risk of breast cancer doubled in every subsequent year the therapy continued; but the number of breast cancers fell sharply within a year after women stopped taking the hormones. This finding supports earlier research that indicated that a nationwide drop in breast cancers was due to women cutting out hormones after they learned of the study. The drop could not be explained by a decrease in mammography, as some had thought.

The researchers say the findings reinforce the advice that women who choose hormone therapy take the lowest possible doses of the two hormones for the shortest period of time. (Women who take estrogen by itself do not face the increased risk.)

Another new study involving more than 68,000 women published this week in the journal Cancer reached similar findings, showing there was about a two-year period where women could take the hormones without the increased risk.

By Rob Stein  |  February 5, 2009; 7:30 AM ET
Categories:  Cancer , Women's Health  
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A lot of it depends on whether you have a family history of breast cancer and/or are worried about getting breast cancer and how miserable you are from menopause.

If someone close to you has had breast cancer, even if you aren't related, you might not want to touch hormones with a ten-foot pole to avoid any additional risk. A lot of women know someone who has had breast cancer and rationally or not would not want to do anything to increase their risk.

Another woman without that personal experience might find the same menopausal symptoms to be totally unacceptable and feel that hormones are worth it to her.

I would add that progesterone cream, available OTC, is a similar element that is in the estrogen/progesterone pill (women are rarley prescribed estrogen alone because it has been shown to increase the risk of uterine cancer) and one should not use that thinking that it is risk free either. Plenty of alternative practitioners advocate this product but the big research proving it is harmless is not there.

Posted by: RedBird27 | February 5, 2009 12:21 PM | Report abuse

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