Hormone Replacement and Cancer
Does hormone replacement therapy (HRT) cause cancer?
Hormone replacement therapy (HRT) is a common treatment used to relieve the symptoms of menopause, especially those with severe hot flashes.
It works by replacing the hormones that are dropping as we enter menopause.
HRT augments the body’s natural hormone levels, either in the form of estrogen-alone therapy (ET), for women who have had a hysterectomy (or surgical menopause), or as estrogen with progesterone therapy (EPT), for women who experience menopause naturally at midlife.
Two of the most common HRT meds prescribed are Premarin and Provera.
Both are synthetic hormones and been known to have a carcinogenic (cancer causing) effect on the body.
Dr. Rishi Verma (a Vancouver-based medical doctor who is the owner and medical director of Balance Medical Center and Westcoast Women’s Clinic) explains on his blog that:
- Contains 20+ estrogens
- All estrogens are derived from pregnant horse urine
- The majority of the estrogens are estrone (E1) compounds, which are unknown to the human body and unfavourable to our body chemistry
- The pill is taken orally, which is a dangerous way to take estrogen, as it has been linked to blood clots
- Synthetic progestogen which bears little resemblance to progesterone
- Has a similar effect to progesterone in the uterus, but a directly opposite effect on all other body tissues
- Is a known carcinogen
- Is strong enough to cause osteoporosis in young women
Bio-identical hormones are hormone preparations which are identical molecules to those produced by the body. These are made from plant chemical, in particular yams and soy.
Many women assume that bio-identical are “natural” hormones are better or safer — but the term “natural” is open to interpretation are not not tested or regulated by Health Canada.
The U.S. Food and Drug Administration said the marketing of these products is misleading to women and that they carry the same risks as other hormonal therapies.
Latest Research on Hormone Replacement Therapy
In 2001 there was a landmark study called The Million Women Study where the researchers there found a link between increased breast cancer risk and hormone replacement therapy.
However, in 2012 a group of experts reviewed the plan and concluded that it wasn’t done properly.
Why did the experts conclude it wasn’t done properly?
Apparently the experts deemed the analysis unreliable because of the way the information was analyzed.
Fast-forward to last August, to the release of a new study aimed to better quantify the size of the risk with the different HRT types.
In this study they used data from a questionnaire on around 40,000 women in the UK.
The study that took place between the years of 2003 and 2015 and assessments were made at recruitment, after 2.5 years and then again at six years.
What did the new study find?
Researchers found women taking combined HRT – both estrogen and progestogen – had just over twice the risk of developing breast cancer compared with women who have never taken HRT.
Women who took the pill for 15 years or more had three times the risk – though this was only seven women in total, meaning the link may have been subject to chance.
The good news.
Thankfully the risk returned to baseline around a year or two after a woman had stopped taking HRT.
Hormone Replacement Therapy and Cancer
- HRT can triple a women’s chances of developing breast cancer
- While the link was first announced in 2001, it was widely disputed
- Conclusion: this latest study shows a link to breast cancer and HRT
The authors of the new study caution women to put this in perspective though (of course they do, it’s not their boobs and body that are at risk).
These findings will be of concern to women taking combination HRT. But there are a few extra points to put this into perspective.
The baseline risk of developing breast cancer with combined HRT is still quite small. This research found no link with the estrogen-only pill.
But we still can’t conclude with complete certainty that it’s only the combined pill that carries a breast cancer risk – particularly when the analyses combining all types of HRT found an increased risk. For now, it has to be considered that any type of HRT could carry a small increased risk of breast cancer.
HRT can also increase the risk of developing other types of cancer. Estrogen-only HRT can increase the risk of womb cancer and is normally only used in women who’ve had a hysterectomy – women who were excluded from this study.
This means we cannot conclude that all women taking combined HRT should switch to estrogen-only – they could be increasing their risk of another type of cancer.
Other potential risks of HRT include ovarian cancer and blood clots. Whether or not the benefits outweigh the risks therefore has to be considered on an individual basis.
The authors call for women to be provided with more information to make informed decisions about the potential risks and benefits of HRT overall, and by the specific type: combined or estrogen-only.
Read more: PubMed Health – Combined HRT breast cancer risk ‘may have been underestimated’
What should you do?
Dr Verma recommends:
Navigating through the world of hormone decline and deciding whether to take HRT is a complex one. If you are considering HRT, please go through the following checklist to ensure your safety:
Only trust the judgement of a doctor who is well versed in the pros and cons of both synthetic and bio-identical hormones
If you choose to take hormones, you should test your levels with a 24 hour urine sample at least once per year, or as indicated by your physician
Do not use oral estrogens – they are strongly linked to blood clots
Do not take anything labelled as a progestogen – this is a synthetic version of progesterone, which bears very little similarity
Use the lowest dose possible to achieve your desirable effect
Ensure you are engaging in appropriate screening for breast and bone health, which your doctor can arrange
Dr. Rishi Verma – read more on his blog.
Are there natural ways to rebalance your hormones
Exercise. I recommend 4-5 days a week. Exercise releases endorphins, our feel-good hormones in the brain.
Soy products, have been shown to help improve hot flashes. Examples are: tofu, edamame, miso, soy milk, soy nuts and tempeh
A healthy diet, high in fruits and veggies. Diet can help impact your mood swings.
Herbal remedies that act like our own hormones. If you do decide to take HRT, ask if you can take an estrogen-only, low-dose formula and try to take it for the shortest time possible. You also may want to ask about vaginal or transdermal HRT.
Decrease your stress with yoga, meditation or deep breathing.
If you do decide to take HRT, ask if you can take an estrogen-only, low-dose formula and try to take it for the shortest time possible. You also may want to ask about vaginal or transdermal HRT.
It’s important to work closely with your physician or other specialist in menopausal health to decide what’s right for you and then monitor on a regular basis.