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[Mary G]

Just to reiterate, it is the progesterone part of HRT that carries all the risks and has the nasty side effects, not the oestrogen part.  It is the oestrogen part of HRT that relieves symptoms, protects your long term health and makes you feel good. 

Some experts believe that oestrogen only HRT can REDUCE breast cancer risk.

The answer is to find an alternative to synthetic/micronised progesterone. 

In the meantime, I think the progesterone component of HRT should be kept to a minimum if possible and oral use should be avoided.

Perhaps the progesterone dose in the Mirena coil could be reduced for HRT use which might make it more suitable for more women.  At present, too much of the progesterone gets into the overall system causing side effects like low mood and breast pain. 

[dangermouse]

Perhaps, the fact that there is a little bio identical progesterone in the OTC creams, and they have not been brought up as having any risk, the Utrogestan would be outside of this study's risks.

I guess we just have to wait for the full report to know more.

[Clovie]

Hmmm. Interesting.
For me personally, the question has got to boil down to - how would the risks of foregoing progesterone altogether (possible endometrial cancer) stack up against/compare with the increased risk of contracting breast cancer. 

I'd guess more likely to contract endometrial cancer, (although I was told by a gynae doctor an arguably easier to treat cancer) - but of course that would have a cost implication of scanning ladies on a regular basis. 

[Fullmoon]

It's interesting isn't it that there are lots of studies about the 'harmful'effects of HRT yet very little research on improving HRT preparations.  In the utrogestan/oestrogel thread Hurdity has posted some links to some small scale studies looking at alternatives ways to give the progesterone element which do not involve continuous use and one consultant recommends use of progesterone 7 days a week per month - and yet the standard 'licensed' route is oral administration continuously or up to 23 days per month.  Why are there no decent large scale trials of these alternative uses of progesterone or trials which look for the smallest amount possible while maintaining a healthy endometrium for those us still with wombs? The reason probably is that drug companies don't want to fund them (because might lead to lower prescribing) and such studies might not be 'sexy' enough for other funders to fund them - no major disease breakthroughs etc - simply improved quality of life for an awful lot of women - no one is going to win a Nobel prize for that. I feel really angry today.... 

Apparently Women's Hour are going to feature this later this week - I'm at work so won't be able to listen live but it would be good if lots of people who have struggled try and get in touch to make sure the voice from this perspective is heard.

[Dancinggirl]

I have to say I was very upset to hear this current bit of news - why can't they pick on other drugs that give bad side effects and risks. Wouldn't we all like an alternative way to relieve our meno symptoms???
To me, it highlights the risks of progesterone, which many of us have problems with anyway.  Surely this opens up the possibilities for a drug company to come up with an alternative way of keeping your womb lining thin - a real money spinner. Why can't they produce a ring (like the Estring) that can be inserted for a few days each month, gives less pregesterone in the first place and possibly giving micronised progesterone directly to that area - this would surely reduce the risk factor? Unfortunately many of us can't use Utro vaginally as the coating causes irritation in the vaginal area - a silicone ring would be ideal

This study was carried out by the Institute of Cancer Research so was of course looking for the cancer risk specifically.
Like Hurdity, I would like to know what the study actually looked at : were life style choices taken into account (e.g. diet and exercise), alcohol intake, what actual types of HRT were used etc. - was Utrogestan part of this study?

I was once employed to help facilitate a medical conference 3 years in a row that was looking at Blood pressure drugs and treatment. Each year there were presentations given by eminent doctors and scientists showing their findings from studies regarding various drugs and treatments - all varied and clearly geared to promoting the use of blood pressure drugs.
At the end of each conference was a rounding up discussion - unfortunately most of those attending had gone home, however, for me this discussion was the most interesting, as they were talking about the prevention of high blood pressure in the first place.  Blood pressure drugs can give some nasty side effects - my mother takes them and feels awful for a couple of hours each day after taking them.  These conferences left me very sceptical about studies in general.

I believe there are now worries over statins which are routinely dished out and give many people very nasty side effects - there is also doubt whether they are truly beneficial. Why aren't they doing more research into this???

Why oh why do they never emphasise the benefits of HRT - there is a balance to be considered.  All drugs have benefits and side effects and this scary stuff will give more fuel to GPs to refuse women treatment and simply ‘kosh' them women with ADs/SRRIs which can also have some nasty side effects.
One of the biggest risk factors for all cancers, especially breast cancer, is being overweight.  ADs/ SRRIs are notorious for making people put on weight - I'm sure if they did a study to look at breast cancer risks for women on ADs/SRRIs they might come up with a similar BC risk factor.  DGx

[breeze]

What it comes down to in the end is if the research was not done, and then published, women would be none the wiser.

However, everyone has the right to the full facts, so they can decide what is best for them.

Can you imagine the outcry if we were kept in the dark or the statistics not checked.

The more information the better, in my view.

[Dorothy]

So, are there not risks in taking contraceptive tablets then, both have progesterone in them.

Yes, it's all hormones - my previous GP used to make muttering noises about me being on it too long because of the risks of BC, my current one is happy for me to stay on it until I'm 50 - I just hope this research won't make her change her mind.   

I'd like to know if the increased risk applies to younger women though... bearing in mind I'm going to be taking some form of hormones for at least the next 9 years...

[RedFraggle]

From the press "39,000 women were monitored for six years. During that time 775 – or nearly 2% – developed breast cancer and women using combined HRT (for an average, median duration of 5.4 years) were 2.7 times more likely to contract the disease during the treatment period than women who had never used HRT."

So 2% got it and the women who had HRT were 2.7 times more likely to get it.  The 2% included woman on and not on HRT. That's 2.7 times a tiny existing risk. Quite frankly, I'll take that to feel normal and I'm only 43 so am going to continue to be on HRT for a considerable time.

[Dediva Ann]

Hello  I have been on HRT for about five months now and aside from the first two weeks on Elleste Duet (when I felt amazing!) seem to be getting no benefit whatsover now.  I was switched to Femoston and for the first three months there were no benefits nor side effects.  Am now three weeks into Femoston 2mg and if anything feel worse. Have hot flushes still, headaches, either can't sleep or am overwhelmingly fatigued, ache all over, have breast pain and tenderness like never before and my nipples are often painfully inverting and need to be tweaked out, have zero libido (it made a welcome return during the first two weeks of Elleste Duet but not since) and am more anxious than ever. Whilst I was happy to ride all this a bit longer on the GP's 'give it time' advice, this news item (though I haven't gone off alarming about it and have read all your very helpful comments above) has made me wonder if I am putting myself at increased risk for what seems like zero benefit. Am scared to go cold turkey though so what should I be asking for please? I am still having reasonably regular periods by the way.  Would really appreciate your wisdom and experience.  Thank you.

[Dana]

Here we go again.... All designed to make women feel bad about using something that makes them feel good. Yet again more women and doctors will be scared away from hrt based on a media story.

No doubt this report will make a lot more noise and get a lot more attention than NICE because that's the way things go with hrt. Everyone loves to hate it because how dare women expect to have something to make their lives easier.

Frankly I don't care what the "research" says. Without hrt the insomnia would make me top myself anyway.

[Freckles]

I am a Chartered Scientist (amongst other qualifications) and I have reviewed the report and it is deeply flawed.
As others have said, it has heavily relied on self report questionnaires.
These are notoriously unreliable and often invalid as people frequently over or under report their symptoms or living habits.  As the old joke says,  the definition of alcoholic is someone who drinks more than their GP.  And as GP friend of mine says he tends to mentally double the units of alcohol some says they consume weekly!
Also it has relied heavily on oral, not transdermal, HRT and too many other variables or factors haven't been considered.
As others have said, it's combined HRT  with progesterone being the health issue and it is appalling that there's both insufficient research and treatment options available for women.
I think the current NHS advice for 200mg of Utrogestan for 12 days a month is both clinically outdated and appalling- clinically often unnecessary, resulting in many women feeling so awful they just give up on HRT and suffer even more.
GP's often are intellectually and clinically challenged when it comes to thinking about  HRT, and I do think HRT prescriptions are too frequently given without thought as to the right HRT: the right dose, the right format and the right frequency. 
The NHS "one size fits all" attitude just doesn't work.
Nor does the often prescribed anti-depressants as an "alternative" to HRT work for women whose psychological problems are hormonal in origin. Albeit it's a cheaper option for the NHS
Basically it's a flawed study.  Unfortunately there is minimal interest by drug companies or the NHS
to address HRT issues per se, to conduct more reliable and valid research,  as both are primarily financially driven.

It's all about reading the facts, not sensationalist news reports and deciding how you want to spend the last third of your life and your quality of life.

Keep calm  and carry on!

[Dancinggirl]

Good post Freckles   DG x

[Freckles]

DeDiva Ann

I am not a fan of oral HRT  (I was on Femoston 1/10 and it did nothing at all for me, although I accept some women finds it suits them) and think the clear clinical evidence for transdermal (gels or patches) HRT  indicate they are safer and more effective.

Don't panic- spend some time to read the many posts on the forum. It may be the case the Estrogel and Utrogestan regime would suit you better. It has been very effective for many women on here compared to oral (tablet) forms of HRT.
Don't go "cold turkey" until you have some more informed information about HRT and can consider your options to ask from your GP.
 

[hotstff]

And here we go again.

Yet another scare story.    I hope they do a proper study, one where they can pinpoint which types of HRT is safe and which methods carry more risk,
rather than put a blanket ban (it's too dangerous) on all HRT again, which is usually the case with these things.   
Are we facing a situation where it will be a battle once more to get GPs to prescribe HRT for women?

Just when we were getting somewhere.   


I don't think my quality of life will be up to much if they refuse me HRT. 
I don't think I'm on my own.

[Sunnydays]

It's been reassuring to read all the different posts. I get very frustrated  about the lack of research that has gone into just what the effective amounts of progesterone might be deemed sufficient to clear the lining build up, rather than a one size fits all.
If you look at the various hrt preparations available under the relevant headings on this site, there's some inconsistency in the amount of progesterone to take eg a 1mg oestrogen dose requires 1mg of Norethisterone, and the higher medium dose of 2 mg of oestrogen also requires 1mg of this progesterone. Both are for 12 days. Yet when you look at the (limited) patches available, the progesterone part has to be taken for 14 days - I reckon the reason 14 days is stated is purely because it ties in with patch changeover days and maybe fewer days would suffice.
Mrs frustrated cheesed off about it all!!