HRT and Breast Cancer: Get the Facts

Estrogen therapy was introduced in 1942 under the brand name Premarin®.[4] Premarin includes a mixture of estrogen hormones derived from the urine of a pregnant horse. Doctors prescribed Premarin to women at the first signs of menopause until the mid-1970s.

In 1975, studies began to emerge, showing that estrogen therapy increased a woman’s risk of endometrial cancer. Then in 2002, the Women’s Health Initiative released a study indicating that estrogen hormone replacement therapy (HRT) increased women’s risk of breast cancer.[5] 

Suddenly, with this information, estrogen HRT became the number 1 enemy of women’s health. 

Doctors stopped prescribing HRT and refused to refill prescriptions, and women were told to manage their menopause symptoms with lifestyle changes. Does “it’s a natural part of aging and to be expected — maybe cut out caffeine and spicy foods” sound familiar?

Breast cancer is a terrible disease. It affects around 12% of American women, with over 276,000 new cases diagnosed every year. The condition causes over 42,000 deaths every year. It should be taken seriously, and all women should learn how to reduce their risk of breast and all types of cancer.[1]

Still, this knee-jerk reaction to one study has led to countless women suffering through menopause symptoms needlessly. Estrogen isn’t the only factor that affects your risk of breast cancer. Since 2002, many more studies have been conducted to evaluate the connection between HRT and breast cancer. 

What are the links between estrogen and breast cancer

Estrogen is one of the hormones that stimulate cell production. Many studies show that women who use HRT have a higher risk of breast cancer than those who use HRT for a shorter period. The studies indicate that the longer you use HRT, the more your risk increases.[3] There isn’t an identifiable plateau. 

However, over the years, there have been several research studies that provide contradicting results. For example, some studies indicate that breast cancer risk increases after two or three years of HRT. Others suggest that a woman’s chance of developing breast cancer rises immediately upon starting HRT. 

But HRT isn’t all bad.

In her book, Safe Hormones, Smart Women, D. Lindsey, Berkson, MA CNS DACBN, outlines several different studies that indicate that HRT doesn’t necessarily cause breast cancer,[2] including a more recent study from the Women’s Health Initiative. 

In the follow-up study from the Women’s Health Initiative, they followed over 8,000 women for more than seven years. They found that women using estrogen (without synthetic progestins) were 18% less likely to develop invasive breast cancer than women who took a placebo. Additionally, the women who took estrogen for the duration of the study had a 31% lower incidence of breast cancer.

Additionally, she outlines a 17+ year study on breast cancer survivors carried out by Dr. Avurm Bluming, an oncologist in California. He followed 254 women and found that when they used HRT, they not only didn’t show any increase in primary or metastatic breast cancer but an overall higher quality of life. 

Is estrogen therapy safe?

The short answer is yes, estrogen hormone therapy is safe.[6] However, if you take HRT, you need to work with a doctor who monitors your hormone levels and overall health. You also need to have an extensive consultation before you begin HRT to ensure it’s an appropriate treatment for your health needs. 

Factors to consider

When you talk to your doctor, there are some critical factors to consider when creating your HRT treatment plan. 

First, what type of HRT are you going to use: estrogen only, estrogen and progestin, or estrogen and progesterone. A similar theme running through all the HRT and breast cancer studies is that synthetic progestin isn’t good for women’s health.

Also, how do you plan to take your HRT? The research indicates that while most oral options are safe, transdermal HRT poses even fewer risks. 

Another topic to discuss with your physician is how long do you intend to use HRT. You might not know the answer to this question right away. Some studies show that the longer you use HRT, the higher your risk of breast cancer. However, a study from the Division of Internal Medicine at McGill University showed that out of the 500,000 thousand women they studied, the majority of the women who got breast cancer didn’t use HRT. Their risk was related to their age and other factors, such as their genes and lifestyle. 

If you have a personal or family history of breast cancer, share the details with your physician. While this doesn’t exclude you from HRT, physicians tend to consider each case individually before prescribing HRT. 

Your lifestyle also affects your risk of breast cancer. You and your doctor review your lifestyle as well as your medical history. Smoking and obesity are common risk factors for breast cancer. 

How do I know if estrogen therapy is right for me?

The best way to determine if estrogen therapy is right for you is to fill out our online screening questionnaire. This starts the process of finding out if HRT is right for you. Once you fill out the survey, one of our physicians reviews it and schedules an online consultation if it looks like you have a hormonal imbalance. 

Your next step is to have blood tests to measure your hormones and screen for other health issues that could cause your symptoms. Depending on your results, our team either creates your HRT treatment plan or refers you to your physician to follow up on your test results.  

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The short answer is yes, estrogen hormone therapy is safe. However, if you take HRT, you need to work with a doctor who monitors your hormone levels and overall health. You also need to have an extensive consultation before you begin HRT to ensure it’s an appropriate treatment for your health needs. 

The best way to determine if estrogen therapy is right for you is to fill out our online screening questionnaire. This starts the process of finding out if HRT is right for you.

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