What All Women Should Know About Hormone Replacement Therapy, Breast Cancer & Dementia

Recently I abstracted an article that examined the link between hormone replacement therapy (HRT) and breast cancer. Many women have successfully used HRT, also known as hormone therapy, to ease the symptoms of menopause. But not all experts agree on its safety.

How Safe is Hormone Replacement Therapy?

A very large clinical trial called the Women’s Health Initiative, which began in 1991, found hormone replacement therapy was correlated to increased incidence of conditions including breast and uterine cancer. These findings, published in 2002, were based on a group of more than 160,000 women who participated in the trial. At the time, news sources estimated that almost two-thirds of woman on HRT stopped therapy due to this new information. The Women’s Health Initiative trial measured the effects of estrogen-only and estrogen-plus-progestin in participants, showing that the use of estrogen alone produced the following results:

• Uncertain effect on breast cancer and uterine cancer incidence
• Slight increased risk of stroke and blood clots
• No difference in risk for heart attack and colon cancer
• Reduced risk of osteoporosis and fracture

Measuring the effects of using estrogen plus progestin, the trial found that the use of both hormone replacements was not beneficial overall. In fact, the use of estrogen plus progestin was correlated to:

• Increased risk of heart attack, stroke, blood clots and breast cancer
• Reduced risk of colorectal cancer
• Fewer fractures

Hormone Replacement Therapy & Dementia

At the time the initial findings were released, there was minimal information on memory and cognitive function. Since then, however, the Women’s Health Initiative Memory Study concluded that estrogen plus progestin therapy did not prevent mild cognitive impairment in postmenopausal women 65 and older, and actually increased risk of probable dementia.

There are pros and cons to every type of therapy. In light of these findings, however, it is recommended that hormone replacement therapy be used only when needed for relief of significant postmenopausal symptoms, and should be used at the lowest dose of estrogen alone, without progestin, that provides relief.

Posted in Diet & Risk Factors, Prevention Techniques, Risk Factors, Risk Factors & Prevention, Senior Health