New Evidence of HRT’s Harm
Remember hormone replacement therapy (HRT) for menopause? It was all the rage for years; a treatment for some of the worst effects of menopause, such as hot flashes and night sweats. It consisted of administering a mixture of synthetic female hormones to mimic those that were in natural decline.
But then new evidence emerged about a decade ago that HRT dramatically increases one’s risk of developing breast cancer, stroke, and venous thromboembolism. After this discouraging news emerged, use of HRT declined rapidly, by about 80%. But the additional risk of developing breast cancer is greater from being obese, or drinking excess alcohol, argue proponents. Some experts still think the risks are worth the relief women may obtain. Accordingly, some women still get HRT from their doctors.
But new evidence has emerged that using HRT, even for a short while, can dramatically increase one’s risk of developing another type of cancer: ovarian. That’s the conclusion of a new meta-analysis—a type of statistical review of numerous older studies—which included more than 20,000 women who had received HRT.
Just a few years of HRT boosted women’s chances of an ovarian cancer diagnosis by a frightening 40%, compared to women who have never taken HRT. Nor did it matter which of several different hormone “cocktails” women were prescribed. For women who took HRT years ago, before the risks became clear, there’s some comfort. The elevated risk of developing ovarian cancer appears to diminish slowly as time off of HRT progresses.
Other factors—such as body size, or the age at which a woman began therapy, or whether she used oral contraceptives, or used tobacco—did not appear to affect this increased risk. "The definite risk of ovarian cancer even with less than five years of HRT is directly relevant to today's patterns of use—with most women now taking HRT for only a few years—and has implications for current efforts to revise UK and worldwide guidelines,” said study co-author Professor Dame Valerie Beral, from the University of Oxford.
If you suffer from unbearable symptoms due to menopause, consider increasing your intake of phytoestrogens, from plant foods such as soy. Evidence shows that Asian women, who consume lots of soy products, do not complain of menopause symptoms to the degree that women in the West do. Researchers think their higher intake of phytoestrogens—plant compounds with weak estrogenic activity in the body—may help protect these women from the effects of rapidly falling natural estrogen levels.
Collaborative Group on Epidemiological Studies of Ovarian Cancer. Menopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies. The Lancet, 2015 DOI: 10.1016/S0140-6736(14)61687-1
Kurzer MS1. Soy consumption for reduction of menopausal symptoms. Inflammopharmacology. 2008 Oct;16(5):227-9. doi: 10.1007/s10787-008-8021-z.
Patisaul HB, Jefferson W. The pros and cons of phytoestrogens. Frontiers in neuroendocrinology 2010;31(4):400-419. doi:10.1016/j.yfrne.2010.03.003.