Hormone Replacement Therapy (HRT) is prescribed for women suffering from severe menopausal symptoms.
Ten years ago, the first Women’s Health Initiative (WHI) report gave rise to a widespread belief that HRT might increase the incidences of breast cancer, heart disease and stroke among the patients and led to a dramatic fall in the number of women opting for the therapy.
Now the findings of the WHI study and HRT”˜s risks and benefits have been re-appraised by some of the leading experts in the field including the clinicians who worked in the original WHI study.
The re-appraisal shows that the risks of HRT had been over-emphasized particularly with respect to a relatively small increase in incidence of cancer among women taking HRT and that HRT can have risks or benefits depending on the time of on-set of menopause, health condition and family history of the patients. In addition, all hormones were placed in the HRT group, and there is a difference between bioidendical hormone therapy and the use of synthetic hormones.
Dr Robert Langer who was the Principal Investigator of the WHI Clinical Center at the University of California in the US now says “Information that has emerged over the last decade, shows that for most women starting treatment near the menopause, the benefits [of HRT] outweigh the risks, not just for relief of hot [flushes], night sweats and vaginal dryness, but also for reducing the risks of heart disease and fractures.”
Dr Langer points out the risk of extrapolation of data and findings for a certain patient group to a larger group when he says “initial results from women who were, on average 12 years past menopause to all post menopausal women has led to the needless suffering and lost opportunities for many.”
He also adds “Sadly, one of the lessons from the WHI is that starting HT [hormone therapy] 10 years or more after menopause may not be a good idea, so the women who were scared away by the WHI over this past decade may have lost the opportunity to obtain the potential benefits.”
Professor JoAnn Manson (Harvard Medical School and Brigham and Women’s Hospital, Boston, MA), who has been one of the WHI Principal Investigators since the study started, said: “An important contribution of the WHI was to clarify that, for older women at high risk of cardiovascular disease, the risks of HT far outweighed the benefits.
This halted the increasingly common clinical practice of prescribing HT to women who were far from the onset of menopause. Unfortunately, these findings were extrapolated to newly menopausal and healthy women who actually had a favourable benefit: risk ratio with HT.
The WHI results point the way towards treating each woman as an individual. There is no doubt that HT is not appropriate for every woman, but it may be appropriate for many women, and each individual woman needs to talk this over with her clinician.”
Breast cancer incidence among women taking HRT was the major issue in the original WHI study. The experts accept that there was increase in breast cancer incidence (when synthetic hormones were used), but say that the increase was small and should not obscure the benefits that HRT can bring to patients with significant menopausal symptoms and low cancer risks.
As per researcher Professor Mathew Allison, the WHI trial results showing the risk of breast cancer from HRT is surpassed by the risk of the disease one has by being obese, not exercising and excess alcohol consumption.
Eluned Hughes, Public Health and Information Manager at Breakthrough Breast Cancer says that there is confusion and differing opinion on the extent of increased risk of breast cancer due to HRT and that women should have access to accurate and adequate information allowing them to make an informed decision on taking the treatment.
But she adds that women taking the HRT “should be closely monitored and reviewed at least once a year.”
Using bioidentical hormones does not increase the risk of breast cancer. Thus, women do not have to worry about this; the risk is the same as if no hormones were used.Â Since the benefits are very high, why not embrace the beneficial potentials of hormone therapy. To learn more, go to Hormone Vitality Plus.
[Source: This write up is sourced from the article “HRT and Breast Cancer Risk Re-assessed”Â by Nicky BroydÂ datedÂ May 22, 2012 WebMD UK Health News]