Helen Seymour is in Peri-Menopause, or at least she thinks she is. In her new weekly column we will follow her on her journey towards the menopause, learning as she does all about the big M.
“… HRT? Oh be careful. Doesn’t that give you cancer? …”
A few different people said this to me, or variations of this, when I mentioned I was thinking about going on HRT. The words “Cancer” and “HRT” have been loosely circling Orbs for over fifteen years now, and here’s the reason why:
HRT was prescribed liberally in the western world since the early 1970s and users derived great benefit from it. The situation changed in 2002 though when a deeply flawed study from the US was published that created concern about a possible link between HRT and Breast Cancer. The study was called the Women’s Health Initiative (WHI) and it was commissioned by the US government to look at many different aspects of the health of older women.
The ladies in the study were almost all over 55 (most participants were in their early 60’s in fact) and they were all offered a daily HRT tablet to take. Some of them were given real HRT (in the form of horse urine Estrogens with or without a balancing Progestogen hormone) and some were taking an identical pill that had no hormones in it at all (a placebo).
Related: I took Testosterone every day for a week and it turned me into a sex maniac
In the first 5 years of the study there was no difference in Breast Cancer detection in the two groups but after those 5 years went by, a slight increase was noticed in the number of Breast Cancers found in the women on the real HRT vs the women taking the placebo. The extra numbers were small and there was no suggestion that the HRT was creating new cancers.
The actual increase in Breast Cancers being found was quoted as “relative risk of 1.26”. This is about the same extra number of Breast Cancers seen in women who drink two glasses of wine a day and far lower than the increased risk that being overweight carries. The information derived from that study did not suggest or prove that HRT caused Breast Cancers to develop.
Sadly, things took an unfortunate turn, because some of the authors of the study wrote a paper about HRT and Breast Cancer without discussing it with most of the other authors. They continue to receive much criticism for this even today.
The popular papers picked up their story and terrifying headlines appeared to say HRT caused Breast Cancer; without ANY actual data to support this. It was so sad for Irish patients during these years. Droves of Irish women, as well as millions of women in the US and Europe, stopped their HRT abruptly, and interestingly sales of anti-depressants rose in an almost exact mirror image.
Related: Hormones are the new black where anti-ageing is concerned
Many women suffered, and no matter how much some Doctors tried to reassure patients about the real facts about the relationship between HRT and Breast Cancer, there were just as many other doctors who hadn’t read all the information and were still warning patients to avoid it at all costs. What is really frightening is that this still happens today with uninformed GPs and Nurses.
Things stayed this way for over a decade until finally in November 2015, the British Government Agency NICE (The National Institute for Health & Care Excellence (NICE), charged with making recommendations and formulating guidelines for doctors and nurses in the UK, published a review of Menopause Care & HRT which reaffirmed what Menopause Doctors had been saying all along which is; if your patient is suffering and needs HRT to control troublesome menopause symptoms, she should feel confident to use it and you should support her in her choice.
This has slowly started a rising confidence in many GP’s about Menopause Care & prescribing HRT and thankfully the conversation around HRT is now a much more accurately informed one.
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My sincere thanks to Dr. Deirdre Lundy MB, BCh, BAO of The Menopause Hub for sharing her report on this matter with me. The Menopause Hub is Ireland’s first dedicated Menopause Clinic. It officially opens on 3rd December 2018.