I absolutely need HRT, I know I do but I am terrified of the bc risks.

[WearsBlackEatsChocolateAvoidsPeople]

I am finding it so difficult to look at things rationally right now and I am making myself feel worse than I already do (peri anxiety is overtaking my life right now). I simply can not stop stressing over hrt and the potential bc risks.

I am 51 and have struggled with perimenopause symptoms for the last 6 years (daily digestive upsets, awful anxiety and depression, anger, headaches, exhaustion, zero libido, aching all over, drying out everywhere and having a very bleak outlook to life). Things are getting worse and nothing I do 'naturally' is helping at all. I am slim (mainly due to the digestive upsets) and I exercise daily (bmi of 21). I don't drink any alcohol (probably had 20 drinks in my entire life) and I have never smoked. I know these are all positives regarding bc risk factors but that does not help me at all right now as I feel that I have higher than average risk factors and feel that maybe I should not take hrt?

I didn't have my dc until I was 32 & 35. I sadly failed to breast-feed them. My mother was diagnosed with hormone sensitive bc this year at the age of 81, these all put me at a higher risk. I really don't know if we have many females with bc in our family because my parents are both only children.(I know mum had two cousins with it, both on her mothers side but neither grandmothers had bc). I am really concerned these factors will put me at a higher risk than the average woman and taking hrt will raise that risk higher. I have seen too many people die from cancer and it terrifies me.

But the flip side to this is that my poor mum also has a pace maker due to heart issues (both her parents died from heart disease), she is bent over with osteoporosis and has Alzheimer's - all diseases hrt is supposed to help prevent. I am probably at risk of these diseases too. It's a double edged sword for me as I certainly don't want to suffer with these diseases as my poor mum currently is.

I am so fed up dealing with a myriad of peri symptoms and I couldn't get a decent answer regarding hrt via my GP due to my mum's bc and the fact I also have endometriosis and adenomyosis so last week I saw a private gynae who specialises in hrt. She has prescribed me Oestrogel (750mcg) 2 pumps daily and Utrogestan 200mg 14 days on and 14 days break.

But I really am very scared to try it......how the heck do I overcome this fear?

Oh and I have read as much as I can and was watching a pod cast (think it was on the Zoe podcast?) with one of the specialists who conducted the original research on the bc risks from hrt in the 1980's and she said they had concluded hrt has the lowest bc risk if you take it just throughout perimenopause. Does anyone know much about this research?

I was also a bit scared - my Mum died following breast cancer. But my friend, who was in recovery from cervical cancer (family history of female cancers) said her doctor had put her on her as it lowered her risk of certain cancers and the benefits hugely outweigh the risks.
Go see your GP. I take it now and feel much better. It's not a game changer for everyone but personally I would recommend it.

I went to a really good menopause talk at work recently. The gynaecologist was asked about the breast cancer risk. She said the increase in risk of getting BC with HRT is so small it's the same as the increased risk from being overweight or drinking alcohol, to put it in perspective.
I think the improvement in quality of life is really worth it if you're having bad symptoms.

The risk of being overweight/obese is 4 times the risk of HRT.

https://thebms.org.uk/wp-content/uploads/2023/01/WHC-Infographics-JANUARY-2023-BreastCancerRisks.pdf

@WearsBlackEatsChocolateAvoidsPeople If you saw a consultant they should have told you that the latest research shows that there is no added risk with breast cancer for 5 years , using Utrogestan.

(You can google this- it's out there.)

Another fact is that there is no added risk of dying from BC for women on HRT.

You could reassure yourself also by paying for an annual private mammogram if you decide to go ahead but the NHS won't do this as you're not considered at high risk (a mum aged 81 with BC doesn't count as added risk.)

1:7 women will get BC, regardless of HRT. There is 1 extra case per 1000 women over 5 years. That's an added risk of 0.4% over 5 years- see the chart linked to. ) And that stat is based on the old types of progesterone, not Utrogestan.

These are the facts but obviously it's absolutely your choice what you choose to do. You need to weigh them up and also consider that your risk of osteoporosis far outweighs the BC risk.

Evidence on HRT helping dementia and heart health is still mixed. But it's very clear on its benefits on preventing osteoporosis. And yes HRT presents a small increase in the risk of breast cancer but osteoporosis has huge impact on quality of life and a hip fracture has a worse survival rate than breast cancer. There are no risk free options but the balance of risk in your case seems strongly in favour of HRT, plus you get the benefit of symptom relief. I'd also encourage getting a DEXA scan to establish your baseline, plus ensuring you are getting strength and impact work to build your bones.