HRT advice

[Sunflowerinmygarden]

Hello
After a recent celebrity having breast cancer on the news today. Im now totally panicking and so worried that I might get breast cancer. Im 47 started HRT 2 weeks ago, (the gel) and progesterone in the evening, im finally feeling amazing, brighter, more sharper in my thinking and clear head/eyesight. No more brutal hot flushes. However im now concerned ive put myself at risk of cancer.
I feel like I did in my 30s happy and full of energy. But now im paranoid.
What shall I do, stop the HRT or carry on for 5 years. 😢

I’ve got an appointment to have the mirena coil fitted soon. It took me ages to decide on what HRT to try and now I’m second guessing my decision and thinking do I go for the one that’s body identical instead? I think sometimes having too much information doesn’t help when trying to choose and my GP hasn’t pushed anything in particular, she’s happy to go with whatever I decide.

It's perception isn't it, for many women bc seems far more scary with the massive altered body image issues post op and then gruelling months of chemo. Not saying I agree obviously but think many see heart disease and osteoporosis as treatable in comparison.

There are risks either way but bear in mind, particularly with the gels that they can and are used in women who have hormone positive breast cancer. The risk is very small. It is also beneficial for your cardiovascular system and bones not just to help with the other perimenopausal symptoms

Yes I agree and that’s my point really. People are worrying about the wrong thing. Woman are far more likely to die from heart disease and most women who have breast cancer end up dying of something else.

Yet everyone is terrified of breast cancer to the point they will avoid something which has a tiny risk to the detriment of getting all the health benefits and could actually improve cardiovascular health.

For example my cholesterol has improved since starting HRT. That’s just one thing.

If people are avoiding HRT because they are worried about a tiny risk of breast cancer then they should also be drinking zero alcohol, exercising 4 times a week, not being overweight. Also never have been on the contraceptive pill, the Mirena coil. Never been an air hostess!

So many things carry a much higher risk….

See I think your ago should guide you, we are not medical professionals.

Yep I do all those things . Was on the pill for 5 years (21-26) and I eat a heart healthy diet ( Zoe) which also is good for brain health and cancer prevention. I do t see the risk as tiny. Maybe because I saw my DM and DFM die from breast cancer. They had treatment and 7 years later it had spread.

It’s easy to say it’s only a slight risk but if it’s your mum or you that is that extra percentage it’s still shit.

Being on the contraceptive pill is associated with a higher risk. As it uses synthetic hormones.

It’s an individual choice but women juts need to be informed. As the 2002
Women’s Health Initiative study (which caused all the fear) has been shown to be completely inaccurate.

I understand. It’s a risk/benefit analysis for everyone.

For me the very tiny risk (many studies show no risk) versus all the benefits. It’s worth it. But I did spend two years reading every study. Many books. Spoke to a private menopause specialist. I feel like it’s a fully informed decision.

https://www.icr.ac.uk/about-us/icr-news/detail/breast-cancer-risk-model-provides-reassuring-data-for-those-with-family-history-of-disease-after-short-term-hrt-use
This is a reassuring up to date article on risk. This is based on 5 years of HRT but my worry is that the Davina led campaigns talked about women being on HRT forever which sounds like it would obviously increase risk more.

I guess transdermal HRT hasn’t been around long enough for them to know the long term risks?

But we are definitely seeing more and more reassuring studies for short term use. Particularly if started before the age of 50/ before menopause.

Yes as that article states; for 5 years between 50-55. But Louise Newson was pushing for the rest of women’s lives!

I can’t work out if the article says which type of HRT? If it’s the old synthetic forms or newer transdermal and micronised progesterone. These distinctions are so important.

Many studies are still using/quoting the older types.

What is true is that we need more research!

I didn't take HRT during perimenopause because of what I'd read about breast cancer risk. I was a fool because my symptoms nearly killed me and I don't think I could live feeling like that forever.

Everyone I have known to get breast cancer has not been on HRT. My menopause specialist told me I had more risk by being obese. This shocked me into losing 3 and a half stone!

I put myself at risk of cancer by smoking for 20 years. I'm definitely not going to give up something that actually gives me quality of life because of a tiny additional risk.

Yes obesity is such a high risk but so many women don’t know this. A while back there were bus shelter campaigns on this but I think it needs to be on the back of every public loo door!

Hmm it just says different types of HRT and durations.

@greengreyblue This article is mainly about those women with a family history of BC..

@Delatron The link to the article is mainly for women with a strong family history of BC who choose to use HRT.

reassuring-data-for-those-with-family-history-of-disease-after-short-term-hrt-use

It does mention other women's risks but there are no links (or I've not seen them) to the stats they have used.

Many of the studies / stats used are out dated (WHI) or flawed (Million Women) and the latest research that was compiled about 3 years ago included all of those.

There are very few studies using micronised progesterone mainly as it's only been used so widely as HRT in the last few years. Those figures are not included as far as I know in these types of 'reports'.

That's not saying there is no risk, but it's not known.

The best advice is from the BMS and they say that micronised progesterone appears safe for 5 years at least and maybe longer.

Again, that is not putting a 5 year limit on HRT it's simply saying the stats are not there one way or the other.

Yes I know. I have a moderate risk.

This is from here. www.menopausematters.co.uk/risks.php

Dr Heather Curry is the author- NHS gynaecologist

NOTE that the stats of the risks do not include women using micronised progesterone. There is very little data on that and the available observational stats show a lower risk compared to other progestogens.

Risks of HRT
Risks associated with HRT include association with increased risks of breast cancer (with long duration HRT), blood clot and, if HRT is started many years after the menopause, possibly cardiovascular disease.

For the majority of women who use HRT under the age of 60, and for many beyond that age, the benefits of HRT outweigh any risks but for some, alternative treatments for either symptom control or osteoporosis prevention/treatment may be recommended or preferred.

Breast Cancer
Current opinion is that HRT taken for less than 5 years does not significantly increase the risk of breast cancer but studies have shown that after 5 years of use, there is an association with a small increased risk. Once HRT has been stopped, the risk returns back to baseline. This suggests that the use of HRT may promote the growth of breast cancer cells which are already present if HRT is taken for more than 5 years after the age of 50, in some women; there is no evidence that HRT causes breast cancer.

It seems very likely that different types of HRT are associated with different risk, estrogen appears to increase the risk very little while there appears to be a small increased risk of cancer promotion with long term use of estrogen combined with progestogen (combined HRT).

The NICE guideline on Diagnosis and Mangement of Menopause concluded that for every 1000 women aged 50 to 59, combined HRT may be associated with an extra 5 cases of breast cancer over 7.5 years, with no extra cases for women taking estrogen only. (NICE guideline)

Thank you for all your clarification on this @JinglingSpringbells

I find it frustrating when studies use the old forms of HRT as we know the problem was with the old form of progesterone which most are not taking anymore.

I personally plan to stay on HRT for as long as I need to. I have found it life changing. I can actually sleep. My mood is stable, I don’t want to murder my husband…! I have zero aches and pains. I could go on.

I would love to see some studies on long term use of the newer forms. But I guess they are not there yet.

I see they’ve taken all the black box warnings off HRT in the US. That’s a start.

I have the mirena coil and oestrogel for my hrt only been on it for the week so far. (I had the mirena initially for problem periods)

I think the oestrogel is making a difference already- I am starting to feel less angry and less fuzzy. Although it is a bit annoying to apply. You need a progesterone course as well as without progesterone the risk of endometrial cancer is increased. (I had to have a new coil fitted)

The best we can all do for our health is a healthy diet, not too much alcohol and to exercise.

My family benefits from me being on HRT as I am starting to feel more balanced.

I also think that the treatments for breast cancer are very well researched now, and with screenings it is caught early now.

I think I am more frightened of getting things like heart failure, or osteoporosis or diabetes or dementia. (It changes)

I think whatever we do something may happen in the future and we won't be able to do much about it.

https://thebms.org.uk/publications/bms-tv/

Lots of info here from experts - worth spending time watching.

Breast screening in the U.K. is once every 3 years as it’s been for decades. My DM was up to date with her mammograms and had only had one the year before she got breast cancer. I agree treatments are better but let’s be real.