Using Hormone Replacement Therapy for Menopause is Safe, New Study Finds
Posted by on October 19, 2015 - 1:11pm

Back in the early 2000s flawed reports surfaced that suggested hormone replacement therapy (HRT) was linked to increased risks of heart disease and breast, ovarian and womb cancers--scientists recently concluded these theories are false. This new research, which followed women for a decade, has found no evidence that HRT is linked to any life-threatening condition! This is good news for the millions of menopausal women who may want to use HRT to control their hot flashes, night sweats, and depression.

HRT boosts levels of estrogen and progesterone and is the most widely recognized therapy to treat severe menopausal symptoms. In the 1940's, the FDA approved the use of estrogen to treat hot flashes associated with menopause. Because women felt better while taking hormones, the list of other beneficial claims relative to the effects of aging grew despite the lack of extensive research. In 1990, the FDA found that the research done to date was not adequate to take hormones to prevent conditions like heart disease. This led to an extensive 15 year, multiphase drug trial called the Women's Health Initiative on hormone therapy for menopausal women, which caused widespread uncertainty for women regarding the safety of hormone therapy and caused many to stop using HRT completely.

Yet this new study by the New York University school of medicine tracked 80 women using HRT for 10 years and compared them with a control group who were not using the medication. The HRT group suffered no more incidences of cancer, diabetes, or heart disease than the control group. Menopausal symptoms can be frustrating and can interfere with daily life. Knowing that there are safe therapies to control these symptoms should be a comfort for women everywhere!

Check out the Women's Health Research Institute's menopause website (menopause.northwestern.edu) to learn more about symptoms and therapy options!

Source: The Telegraph

Breast cancer, HRT, and Alcohol
Posted by on September 7, 2012 - 8:02am

An analysis among more than 40,000 postmenopausal women who were in the California Teachers Study was carried out to determine if there were differences in risk of breast cancer among women consuming alcohol according to their previous or current use of hormone therapy (HT).  In the cohort, 660 women were diagnosed with invasive breast cancer during follow up.

Results showed an increase in risk of breast cancer among alcohol consumers of more than 20 grams of alcohol per day (about 1 ½ to 2 typical drinks) who were current users of HT but not among those who were ex-users of HT.  The authors conclude: “Following the cessation of HT use, alcohol consumption is not significantly associated with breast cancer risk, although a non-significant increased risk was observed among women who never used HT.  Our findings confirm that concurrent exposure to HT and alcohol has a substantial adverse impact on breast cancer risk.  However, after HT cessation, this risk is reduced.”

Forum reviewers considered this to be a very well done analysis on a large group of post-menopausal women with repeated assessments of alcohol consumption and HT use.  However, results from even very large studies on the relation between alcohol, HT, and breast cancer risk have often been conflicting.  Even with numerous studies on this topic, we still have very poor predictors of which women will develop breast cancer.  There is some increase in risk for women with a family history of such cancers and those who are obese.  However, the percentage increases in risk associated with HT, alcohol consumption, and other environmental factors are generally small (unlike the many-fold increase in the risk of lung cancer among smokers in comparison with never smokers).  This may explain why the results of individual studies may reach apparently conflicting conclusions.  While the present study suggests that women who consume alcohol may have a decrease in their risk of breast cancer if they stop taking hormone replacement therapy, our current understanding of factors affecting breast cancer risk remains quite inadequate.

Reference:  Horn-Ross PL, Canchola AJ, Bernstein L, Clarke CA, Lacey JV, Neuhausen SL, Reynolds P, Ursin G.  Alcohol consumption and breast cancer risk among postmenopausal women following the cessation of hormone therapy use: the California Teachers Study.  Cancer Epidemiol Biomarkers Prev 2012. [Epub ahead of print]

The Pill, HRT and Pregnancy may Increase Risk for High Blood Pressure
Posted by on March 31, 2011 - 3:32pm

Women who tend to have high blood pressure (HBP) should be particularly vigilant if they are on oral contraceptives, are pregnant, or on hormone replacement therapy.

Women on oral contraceptives (OC) experience small but detectable increase in both systolic and diastolic blood pressure, usually in the normal range.  If it runs higher than normal make sure you talk to your doctor about it.   Women taking OCs who are 35 years and older and who smoke cigarettes are at even greater risk for heart disease and stroke and are encouraged to quit smoking.   If they are unable to quit smoking, they should talk to their doctor about using other forms of contraception.

Most studies show that blood pressure does not increase significantly with hormone replacement therapy in most women with and without high blood pressure.   However, a few women may experience a rise in blood pressure attributable to estrogen therapy.   It is recommended that women on HRT have their blood pressure monitored more often.

Many woman with HBP can have healthy babies but HBP during pregnancy can be dangerous for both mother and fetus.  Women with pre-existing, or chronic, high blood pressure are more likely to have certain complications during pregnancy than those with normal blood pressure.   Some women who have normal blood pressure before pregnancy may develop high blood pressure during pregnancy, called gestational hypertension.   The effects of high blood pressure range from mild to severe.   High PB can harm the mother's kidneys and other organs, and it can cause low birth weight and early delivery.  In the most serious cases, the mother develops pre-eclampsia or "toxemia of pregnancy" which can be life threatening.  More guidance for handling HPB during pregnancy can be found HERE.

Below is a chart for average normal blood pressure ranges.   However, age can effect the range, with slightly higher normal ranges as one ages.

Systolic pressure (mm Hg) Diastolic pressure (mm Hg) Pressure Range
130 85 High Normal Blood  Pressure
120 80 Normal Blood Pressure
110 75 Low Normal Blood  Pressure

Source:   National Heart, Lung and Blood Institute

Hormone Therapy and Breast Cancer Risk
Posted by on February 10, 2011 - 2:24pm

Starting Hormone Therapy at Menopause Increases Breast Cancer Risk

Women who start taking menopausal hormone therapy around the time of menopause have a higher risk of breast cancer than women who begin taking hormones a few years later. The finding, from the Million Women Study (MWS)—a large observational study in the United Kingdom—adds to a growing body of evidence that the use of combined hormone therapy (estrogen plus progestin) to treat menopausal symptoms increases the risk of breast cancer and deaths from the disease. The results appeared in the Journal of the National Cancer Institute on January 28.

The pattern of increased breast cancer risk “was seen across different types of hormonal therapy, among women [in the MWS] who used hormonal therapy for either short or long durations, and also in lean and in overweight and obese women,” Dr. Valerie Beral of Oxford University and her colleagues wrote. Their findings support results from the Women’s Health Initiative (WHI), a randomized clinical trial that, in 2002, first reported evidence linking combined hormone use to breast cancer.

“The new findings underscore the idea that there’s really no safe window of time for women to take combined hormone therapy,” said Dr. Leslie Ford of NCI’s Division of Cancer Prevention and the Institute’s WHI liaison. After the initial WHI results were announced, she noted, some people had argued that hormones may be safer when started at the time of menopause. “The new findings refute that argument,” she added.

WHI and MWS investigators have both reported that breast cancer incidence rates declined rapidly once women stopped taking combined hormone therapy. “It is important for women to know that if they stop using hormones, the risk of breast cancer very quickly returns to where it was before hormone therapy began,” Dr. Ford said.

There has been a discrepancy between the WHI and MSW results to date as to whether estrogen-only therapy raises breast cancer risk in postmenopausal women. WHI reports have found little risk associated with this treatment, whereas the MWS investigators have observed a statistically significant increased risk.

Additional follow-up from the WHI estrogen-only intervention trial should help clarify this issue in the coming years, noted Drs. Rowan T. Chlebowski of Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center and Garnet L. Anderson of the Fred Hutchinson Cancer Research Center in an accompanying editorial.