Once again we are returning to the question of whether menopausal hormone replacement therapy (HRT)increases breast cancer risk.

The recent issue of Journal of Family Planning and Health Care contains an article by two researchers who argue that the data used in the previously reported Million Women Study is too flawed to support its widely-heralded finding that HRT use increases breast cancer risk.

The Million Women Study is an observational study that found that women who used estrogen and progestin had an increased risk of developing breast cancer. It is well understood that epidemiologic studies like the Million Women Study can only prove correlations, and not cause and effect. In fact, there are several observational studies that supported the use of HRT to prevent heart disease, a finding that was not born out when randomized trials were done.

Moreover, the Million Women Study is not the only study to come to this conclusion nor is it the key study most researchers point to when talking about the risks associated with HRT. That study is the Women’s Health Initiative, a randomized placebo-controlled trial that was specifically designed to measure the benefits and risks of menopausal hormone therapy and that was stopped in July 2002 when an interim data analysis indicated that the risks of this therapy outweighed any benefits the drugs had to offer.

The WHI confirmed what observational studies like the Million Women Study had found. And it was the WHI that shifted the way women and their doctors think about HRT. Furthermore, over the past decade, a number of studies have been published that have shown that as large numbers of women stopped using HRT, breast cancer rates went down.

Unfortunately, this article appears to be getting quite a bit of media play. Why do I say unfortunately? Because pointing out the problems with the Million Women Study in no way invalidates the WHI results, nor does it change the advice we have been giving women for the past decade: only use menopausal hormones if you need them to help with menopausal symptoms, like hot flashes, take the lowest amount that is effective, and only stay on them for as short a time as necessary.

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5 Responses to HRT Questioned Again – Really?

  1. Jonathan says:

    Beyond appalling. We might as well be questioning whether cigarettes really were all that dangerous to begin with!

    OK, big deal, MWS was observational. But WHI and MWS corroborated one another – hormones both cause cancer and increase the likelihood of their being fatal. Fortunately, women have gotten the message and quit/never started HRT and we can thank these wise choices for a global worldwide decrease in breast cancer incidence.

    A few patronizing pharmaceutical shills who spit on science by extolling their “expertise/credential” is not going to move a mountain and change the public’s collective knowledge that HRT is in fact dangerous.

  2. Judy Griffin says:

    What needs to be addressed is the effect of Bio-identical hormones on Breast Cancer. There are numerous studies & opinions in the book “Sex, Lies, & Menopause” that make a compelling argument for the positive effect they have on Breast Cancer and other diseases. Would love Dr. Love’s opinion on this topic.

  3. Susan says:

    I got estrogen posative breast cancer after being on bio identical hormones for 7 yrs.

  4. It is really important that we balance hormones as naturally as possible, and measure and detoxify them. In working with thousands of women I created the program http://www.womensrestorativehealth.com to address the 7 key areas:

    1. Mental and spiritual
    2. Environment and inflammation
    3. Nutrition
    4. Digestion
    5. Detoxification
    6. Hormonal balance and sexual health (see http://www.sexualcpr.com/helpdoctor
    and 7. Structure and function

    Protecting ourselves from cancer is about creating a body inhospitable to cancer!

  5. Jessica S says:

    This has more to do with the recent court rulings against Wyeth/Pfizer on HRT causing breast cancer. Jonathan’s tobacco analogy is right on. The drug companies have tens of millions of dollars set aside to settle with women who took HRT and got breast cancer. Internal memos are the smoking gun, showing that they knew HRT led to breast cancer and withheld that info from the public.

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