Healing Metaphysics Home > Archive> A Certain Age (HRT Risks and Benefits)

The Weekend Australian - August 30-31, 2003
Copyright News Limited
Hormone replacement therapy has again come under scrutiny, with studies this month linking it to increased risks of breast cancer and heart disease.

HRT is the use of oestrogen or a combination of oestrogen and progestin medication to replace hormones that the ovaries stop producing at menopause.

It is generally prescribed to relieve menopausal symptoms such as mood swings, hot flushes, vaginal dryness, night sweats and urinary irregularities.

Hormone replacement is also thought to reduce the risk of osteoporosis brought on by declining oestrogen levels late in life.

Touted as a wonder drug in the past - despite lack of clinical trial evidence - HRT is now increasingly dogged by bad press.

This year alone it's been linked to heart disease, breast cancer, dementia and stroke.

Oxford University's Million Women Study claims post-menopausal women using combination HRT are twice as likely to develop breast cancer as non-users.

These effects are said to wear off within a few years of ceasing treatment.

And the final report of the American Women's Health Initiative, released in August, reveals an increased risk in heart disease for post-menopausal women using combination HRT.

Ironically, it was the belief that hormone therapy reduced the risk of heart disease that led to its initial widespread use.

Rose Brown's doctor recommended she start HRT at the onset of menopause 10 years ago. Now 60, Rose believes the benefits of HRT outweigh the risks, and says recent research results don't scare her.

"The cancer thing doesn't bother me because I'm regularly checked," she says.

When American researchers abandoned a major clinical trial of combination HRT after discovering an increased risk of invasive breast cancer last year, Rose tried to give up HRT.

"I couldn't," she says, "I woke up all through the night, plagued by hot flushes. I had to go back on it."

Prince Henry's Institute of Medical Research's Henry Burger says the results of the Women's Health Initiative and the Million Women's Study must be put into perspective.

Professor Burger says the results roughly translate into one extra case of heart disease or breast cancer per 250 women treated over a five-year period. "That risk is considerably less than the risk of suffering injury in a traffic accident over the same period in our community," he says.

Burger believes hormone replacement is the optimal treatment for a woman experiencing moderate to severe symptoms associated with menopause.

"It's essential for the prescribing doctor to discuss the evidence of benefit versus risk. Such therapy is usually given for less than five years - for that time, benefits clearly outweigh the risks."

However, he says, hormone replacement for the prevention of heart disease in women who are already several years past the menopause, is not recommended.

Women should discuss their particular circumstances with their doctors as individual factors may affect the risks and benefits of treatment for them.

Sarah Saunders.
Links National Women's Health Information: www.4woman.gov

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