It can be like magic for women who feel their life is wrecked. Most women go through the menopause between the ages of 45 and 55, although for some it happens prematurely and others are thrown into it by cancer treatment to stop the body producing oestrogen, as the hormone feeds breast and ovarian cancers.
The first oestrogen pill was introduced in , and HRT became available to women in the UK in , without the sort of trials that would be done today to look at the side-effects. The rationale was clear: the pills replaced the oestrogen women were losing. Without any evidence, the suggestion was planted that HRT would restore both vigour and beauty. The science came later and caused much dismay.
Both found an increased rate of breast and ovarian cancer. Thousands of women stopped taking HRT. Thousands more were anxious about starting it. The pendulum has recently swung back the other way, with guidance from Nice, the National Institute for Health and Clinical Excellence, in November Millions of women should no longer have to suffer in silence, it said.
An estimated 1. HRT worked, Nice said, and should be considered. And now the WHI study has published its long-term findings showing women do not die from taking it. Hamoda is also on the medical advisory council of the British Menopause Society which has lobbied for HRT and disputed the risk findings in the past. Hamoda says the breast cancer risk is not high. The WHI study puts it at one more case in 1, It is similar to the [breast cancer] risk of drinking a glass of wine a night.
A more recent study, from the Institute of Cancer Research in London, found last year that among the , women taking part to look at the causes of breast cancer, those on HRT had a 2. The risk is higher for woman taking the combined oestrogen and progesterone pill and lower for oestrogen only — but women need progesterone to protect against womb cancer unless they have had a hysterectomy. Gynaecologists like Hamoda understand the need. The average duration of symptoms is seven years but one in three go beyond that.
Author Jeanette Winterson described two years of mental breakdown. But conventional doctors say there is no difference. Women are given oestrogen in the form of estradiol on the NHS, which Hamoda says is bioidentical — identical — to that made in the female body. The progesterone that most women get is synthetic, but bioidentical micronised progesterone, made from plants, is also available on the NHS.
After about 18 years of follow-up, 1, cases of breast cancer were diagnosed in the group of women treated with combination HRT. Women treated with combination HRT also were more likely to die from breast cancer compared to women treated with placebo, but this difference was not statistically significant, which means that it could have been due to chance and not because of the difference in treatment.
So the issue is far from resolved. Menopausal side effects can dramatically reduce quality of life for some women. These women have to weigh the benefits of HRT against the risks. If you're having severe hot flashes or other menopausal side effects and are considering HRT, talk to your doctor about all of your options.
Ask how you can minimize your breast cancer risk and relieve your symptoms. Be sure to discuss the pros and cons of different types and doses of HRT. If you do decide to take HRT, try to take the lowest dose possible that still meets your treatment goals. You may want to ask your doctor if estrogen-only HRT is a good option for you.
You also may want to ask your doctor about vaginal or transdermal HRT. Learn more about menopause and ways to manage side effects on the Breastcancer.
Written by: Jamie DePolo , senior editor. Reviewed by: Brian Wojciechowski, M. Create a profile for better recommendations. For more detailed information about the cookies we use, see our Cookies page. You can browse all our evidence-based and unbiased information in the Menopause Library. Get the balance app. Share this podcast. Similar content. Brain fog or dementia?
0コメント