Too much oestrogen causing breast cancer?

[ShornTheSheeep]

I have been prescribed HRT preventatively by my rather forward thinking GP. Trouble is, I'm too scared to take it!!

I'm 51, regular periods with only a few symptoms, mainly the odd sleepless night and some stiffness during the month which comes and goes. No hot flushes or anything like that.

I'd like to take it to ease the stiffness if possible and get back to proper sleep but I read stuff like this (please see my copy and paste below!) and wonder if it's worth the risk ... definitively, does it raise your risk? I know they say no but thoughts?

There are many different types of breast cancer. Around 70 per cent of them are sensitive to the female sex hormone oestrogen. Cells from these types of cancer have receptor sites that bind to oestrogen, which promotes their growth and spread.

I'm assuming you're getting much less oestrogen through hrt than you naturally produce before menopause. Haven't looked into it. Keep up with self-checking and any invitations for scans etc, and take it.

The latest (mainstream and evidence-based) medical thinking is that any increased risk of breast cancer is very marginal - and the benefits of HRT outweigh the risks, particularly in terms of avoiding osteoporosis. That's why I take HRT. Have you talked it through with your GP?

It's complex and there are lots of different risks you need to take into consideration so it's really worth doing some reading. Taking estrogen alone actually reduces your risk of breast cancer, but if you still have your womb you need to take progesterone with it to avoid the estrogen increasing your risk of endometrial cancer. Combined HRT (estrogen and progesterone) does slightly increase your risk of breast cancer but to put it into perspective that's about the same increase as drinking 2 units of alcohol per day, and six times smaller than the increased risk of being overweight or obese.

But it's important not to look at the breast cancer risk alone - breast cancer is of course a horrible disease but HRT protects against osteoporosis which can make minor falls disabling or fatal.

Taking it as a preventive is a tricky question where we need more longer term data to really weigh up the risks, particularly of modern bioidentical HRT which seem likely to be lower risk than earlier forms. But if you're suffering from lack of sleep and stiffness that is probably making you less active - and lack of exercise is a huge risk factor for breast cancer, circulatory disease and other major killers. I'd say take the HRT and use the increased energy and mobility it should bring you to get out and about more, offsetting the small increased breast cancer risk from the HRT while giving you overall much better life and health.

Lifestyle choices such as drinking even a small amount of alcohol, being overweight and lack of exercise are far more closely linked to cancer than HRT. And there are clear health benefits from HRT such as a reduction in osteoporosis. Some women need to be more cautious because of a family history of some cancers.

The research is not conclusive but what they think is that in some women, HRT may accelerate an existing cancer, that would grow anyway, but take longer without HRT.

It's not the estrogen that is the risk factor, but when it's combined with progestins.

Explained well, here by a consultant gynaecologist.

www.menopausematters.co.uk/risks.php

www.menopausematters.co.uk/risks.php

The risks (if there are any) are small and the stats show around 4 extra cases per 1000 women, using HRT for 5 years. So that's less than 1 extra case per 1000 women per year.

Obviously, it's up to you if you feel the risk is unacceptable and worries you.

As a PP says, there are some small risks, but there are also risks not using HRT.

Interestingly, HRT is not licensed as a preventative unless a woman already has a high risk of osteoporosis, or already has low bone density, called osteopenia, or a family history of it. Has your GP talked to you about the pros and cons?

Presumably, it's been prescribed partly for your insomnia.

I found this podcast useful, from the British Menopause Society;

Thank you all - some interesting points and I'll read the links.

I've read quite a bit myself but this is what is stopping me from taking HRT I think!

My GP didn't prescribe for any other reason than I asked for it. Happy to prescribe preventatively - so on the one hand, forward thinking perhaps - but just wasn't able to answer any of my questions really because the newest research seems to be something they're yet to hear tbh in a lot of cases.

I felt I was being asked what I wanted and they'd give me it. So I'm not filled with confidence that I've received proper advice tbh

This shows breast cancer risk in context

That's incredibly helpful @over50andfab - thanks for posting it!

@MilkshakesBringAllTheCoosToTheYard I tried to post the same as @over50andfab as it's linked further down the page on my first link, but it didn't work! That's why there are two links the same!