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Does hormone replacement therapy increase the risk of cancer?

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The belief that hormone replacement therapy (HRT) increases the risk of cancer, particularly breast cancer, is partly rooted in earlier studies, notably the Women's Health Initiative (WHI) study from 2002. This study initially reported an increased risk of breast cancer, heart disease, and stroke among women taking combined HRT (oestrogen and progestin). The findings created widespread concern and led to a significant drop in HRT use.


However, further analysis and subsequent studies have provided more nuanced insights:


Type and Duration Matter


The risk associated with HRT varies based on the type (combined oestrogen-progestin vs. oestrogen-only) and duration of use. Combined HRT has been associated with a small increase in breast cancer risk, particularly with long-term use. Oestrogen-only HRT (for women who have had a hysterectomy) does not carry the same risk and may even reduce the risk of some cancers.


Age and Timing


The timing of when a woman starts HRT also matters. Starting HRT closer to menopause appears to have fewer risks and may even provide cardiovascular and bone health benefits, while starting HRT later (more than a decade after menopause) can carry higher risks.


Misinterpretation and Misinformation: The original WHI study was widely reported, but the nuances and later findings have not always been as well communicated. As a result, many women and healthcare providers have a lingering fear of HRT, despite evidence showing that the risks can be minimized, especially with personalized treatments.


Individual Risk: The risk of cancer or other conditions from HRT depends on a woman’s personal health history, family history, lifestyle, and the type of HRT. For some women, the benefits of HRT, including relief from severe menopausal symptoms and protection against osteoporosis, outweigh the risks.


While there is some basis for concern about HRT and cancer, particularly breast cancer, it is not as simple as HRT being inherently harmful. Misinformation or oversimplified interpretations of older studies continue to contribute to fear around HRT. Today, many experts agree that HRT can be a safe and effective treatment for menopausal symptoms when used appropriately under medical guidance.


If you have concerns, please discuss with you GP.



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