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The Big HRT Debate… will it ever go away?

It feels like the HRT debate right now is doing a pretty good job of challenging Brexit for our attention.

You’d be hard pushed not to have been exposed to the recent tabloid headlines, once again demonising Hormone Replacement Therapy and terrifying us poor, deranged, red faced, neurotic midlife women into believing the only choices we have are to remain neurotic or face the dreaded ‘C’ word.

Not many weeks ago the news was full of stories of women having to travel to countries far and wide to source their sanity saving hormones, since there appears to be an inability on the part of the suppliers to produce sufficient quantities of these drugs (apparently this may all be part of the Brexit shenanigans too!).

Now, just a week or two later and it would appear that these women needn’t have wasted their time and effort since they’re all going to die of breast cancer if they take the damned medicine anyway!

I’m not one for conspiracy theories, but even I can’t help but see the irony in the timing of this latest report, from a very reputable source, the medical journal The Lancet.

Is There Anything New in this Report?

 

Much of the information in this most recent report is old news.   However, these new findings do suggest that the risk of developing breast cancer as a result of taking HRT may last longer than previously suggested and that the incidences of breast cancer may be greater than previously thought.

However, according to former Chair of the British Menopause Society and Director of the specialist menopause service Peppy Health, Kathy Abernethy, it is important that women are fully informed about the risks of taking HRT to help them make an informed decision.  What this current report fails to do though, is to offset the risks with the many short and longer terms health benefits.

The study is also incomplete.  It doesn’t include the impact of other lifestyle factors such as body fat percentage, alcohol intake or stress levels.  Nor does it identify the mortality rate of those diagnosed with breast cancer.

Kathy Abernethy also points out that this study does not include all current medications, for example micronized progesterone (Utrogestan) which is considered to be safer than other forms of progestogen.   Plus, much of the information in the study was based on older forms of HRT and does not include modern types of HRT currently being prescribed.

You can read Kathy Abernethy’s article ‘HRT and breast cancer – what should women on HRT do’ here.

Is There An Increased Risk of Breast Cancer linked to HRT?

 

In a word, yes.   I don’t believe anyone is denying that there is a small increase in the potential of developing breast cancer for women who choose to take HRT.  The NICE guidelines with regard to menopause direct medical practitioners to discuss the potential risk with women before they prescribe HRT.

But it is important to look at possibility against probability.  Yes, there is a possibility of developing breast cancer but the probability is still low, I believe the latest statistic is 4 women in 100.  That suggests a 4% chance of developing the disease versus 96% of not doing so.

According to the charity Breast Cancer Care, 9 in 10 women will survive breast cancer for 5 years or more.   They also state that 1 in 7 women in the UK will develop breast cancer in their lifetime.

Coronary heart disease, according to Heart UK, is the number one killer in the UK for both men and women, yet despite the fact that there is evidence to show that HRT can improve heart health, this ‘benefit’ is seldom included in the scary news articles.

Pretty much everything we do in life carries some element of risk.  We get into our car to drive somewhere and we are taking a risk.  But, we weigh up the probability of risk against the benefit of being able to conveniently get to the place we want to get to.

When you pour that glass of red (or 3) do you consciously worry about the increased risk of breast cancer from the alcohol?  I actually doubt it, and yet the risk is higher than it is from taking HRT.

We have to weigh up the small risk of breast cancer against the benefits of improved quality of life and long-term health benefits and make our choice based on facts and risk assessment rather than on fear and misinformation.

What Should Women Do?

 

What women should do is totally and utterly a personal and individual choice.   But my advice would be to go away and do your research.

Weigh up the facts – facts gleaned from balanced, well informed sources such as The British Menopause Society website.  Newspapers have one job – to sell newspapers!  There is little likelihood of getting balanced, well informed information from a newspaper article.

Think about your own philosophy with regard to taking medication.  What ‘feels’ right for you?  Weigh up the balance of probability against your current health and wellbeing.  How are your symptoms affecting your day to day life and would the benefits outweigh the risks by getting additional help from HRT.

Speak to your medical practitioner, preferably one who is well versed in current facts.  You may prefer to ask for a referral to a dedicated menopause clinic or even seek help through a private clinic.

What women absolutely shouldn’t do is panic.

 

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