Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: kdee69 on August 30, 2019, 04:15:08 AM
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Thought I'd post this for anyone who wants to read it
https://www.theguardian.com/science/2019/aug/29/breast-cancer-risk-from-using-hrt-is-twice-what-was-thought?CMP=Share_iOSApp_Other
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Hello Ladies
I was just about to post the link!
I've not been here for a long time partly because I've been doing ok plus I was getting too focussed on health etc and it was creating more health anxiety! Hope everyone is doing ok....
Bit worrying though as I've been on it quite a few years now, hope to come off it by 60 when I can start winding down work wise (I hope!) but whilst everything is ticketyboo (good sleep, no stress etc) I'm fine but then if I get run down it seems to knock my hormones out of balance and all the yukky symptoms return.
What's a gal supposed to do? Always feel you're between a rock and a hard place. Feel well or not feel well and less risk? I know there are other factors at play, genetics, even alcohol consumption, diet etc but this study doesn't look good. :(
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Thanks kdee69. Very interesting article.
It's on the news this morning.
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Why all this scaremongering again, not too long ago we were getting the opposite message, that the risks were not as bad as thought and promoting all the good aspects, heart and bone protection and how women had suffered unnecessarily by years of not taking HRT etc.
lts ironic how this news coincides with the shortages and many will be now scared to use it, one way of solving the shortage problem.......
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I just heard it on the news too, 6 in 100 will get it with no treatment, but that goes up to 8 in 100 if hrt is taken for up to 5 years.
I don't know if it's just me thinking it as I am one of those untrusting people, but I find the timing of this report being released a little unnerving x
Tracey E I thought that, but also what about taking birth control pills as they are stronger than hrt x
The BBC news one
https://www.bbc.co.uk/news/health-49508671
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Why all this scaremongering again, not too long ago we were getting the opposite message, that the risks were not as bad as thought and promoting all the good aspects, heart and bone protection and how women had suffered unnecessarily by years of not taking HRT etc.
lts ironic how this news coincides with the shortages and many will be now scared to use it, one way of solving the shortage problem.......
I think the article isn't necessarily scaremongering but presents the reports of the Lancet study and allows women and doctors to make informed choices. I personally will weigh up the pros and cons and then decide whether the risk is worth it compared to the utter crap I feel when not on HRT. I will never forget a woman I worked with years ago who had the most miserable time going through the menopause, fanning herself through every meeting, barking at everyone daily and just having a crap existence telling me that she'd never take HRT as it “causes cancerâ€. She suffered for literally years. I honestly swore if I'd ever become like her, the risk was worth it. Fast forward 15 years and it absolutely was me. I definitely want to read this article in greater detail and consider everything but even now, on first reading, I don't want to be that woman ever again so I think HRT for me still may be the better option.
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Government going to the country might have an impact?
Quality of Life Girls! We might die of something else whilst taking HRT [I don't] before cancer cells grow anyway. Will be interesting to see Dr Currie's take on this.
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I don't think you can blame the researchers for scaremongering. You would not want them not to do any research or not publish adverse affects as that would be worse for everyone.
If you click the lancet link in the article you get the full research results.
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Crikey - the Telegraph have cherry picked big time. These articles shouldn't be allowed.
Their statistics show a possibility of 1 more woman being diagnosed with breast cancer over 5 years if HRT is used. What the F*** is MHT [off to check that]
Menopausal hormone therapy (MHT) essentially replaces the missing hormones to alleviate menopausal symptoms.
It is commonly referred to as HRT (hormone replacement therapy), although this also includes other therapies such thyroid hormones, growth hormones or testosterone which are not part of this study.
I didn't read any more and DH says that women probably haven't been asked about lifestyle, diet, weight, smoking, alcohol etc.. Stastitics being manipulated again?
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Exactly CLKD, statistics can be interpreted differently. But the information has to be out there for women to make an informed decision.
You wouldn't want the research done and not published as is done with statins where the drug companies refuse to release their data.
No doubt the pharmaceutical companies involved will dispute this paper but at least it was written with no commercial interest.
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This study is not a randomised controlled study which is the gold standard. Like many have commented it doesn't reflect lifestyle such as drinking, smoking or obesity. Also from what I can see it doesn't include micronised progesterone such as utrogestan but many of the old synthetic progesterones which have always shown an increased link to breast cancer. Just my own personal insight into this paper.
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I think this is scaremongering!
I've taken it for 20yrs almost. These reports always come out! It's good, it's bad ect! Like alcohol they say a glass is good then it's not.
If you are getting a better quality of life then to me that out-ways the risks.
Having ME if someone gave me a choice I'd take the risk.
I started taking it at 27 due to early menopause so I'm apparently not as risk just putting in what my body dose not produce but I'm bad enough with it. And having the longest menopause ever no way will I not take it. (I have tried) xx
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Here is the RCOG and BMS response which I haven't read yet:
https://www.rcog.org.uk/en/news/rcog-bms-response-to-lancet-study/
I haven't had time to read the paper in depth yet as have to go out but looks very complex (and need to be a statisitician to understand it!) and as newbaby1234 says it is not a randomised controlled trial but I think what is known as a meta-analysis ie putting together data from a lot of different studies ( including trials) and analysing the results. It cannot go into very specific types of HRT which is what later trials have done. eg I would want to know the relative risks of using transdermal HRT with micronised progesterone used intermittently, compared to non-use of HRT. Some large analyses have been presented of oral vs transdermal but not sure what. Looks like cyclical progestogen associated with lower increased risk than continuous combined - but that is not new. Also the info refers to lower increased risk from dydrogesterone (compared with other synthetic progestogens?) - but that has also been reported before. Not sure about all the details re follow up.
Hurdity x
Edit The study was carried out by the same team from Oxford University that carried out the Million Women Study - they interviewed Prof Valerie Beral, one of the authors of the current study this morning on Radio 4.
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Have read the Lancet article which makes for sobering reading. Also some of the various comment pieces. Don't think it scaremongering. One article I read deemed the study well-designed & an excellent piece of research. Need time to digest it. Will be interested to see what NICE have to say.
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You can read Dr.Currie's response to the article here:
https://www.menopausematters.co.uk/newsitem.php?recordID=204
Also the link to the bms article here (https://thebms.org.uk/2019/08/bms-response-to-lancet-paper-on-the-link-between-different-forms-of-hrt-and-breast-cancer-incidence/)
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Morning Ladies!
What a morning! Let's not panic!
This is worth a read
https://www.dailymail.co.uk/debate/article-7409263/Yes-cancer-risks-Id-prescribe-HRT-writes-breast-surgeon-PROF-KEFAH-MOKBEL.html
W xx
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I just heard it on the news too, 6 in 100 will get it with no treatment, but that goes up to 8 in 100 if hrt is taken for up to 5 years.
I don't know if it's just me thinking it as I am one of those untrusting people, but I find the timing of this report being released a little unnerving x
Tracey E I thought that, but also what about taking birth control pills as they are stronger than hrt x
The BBC news one
https://www.bbc.co.uk/news/health-49508671
Yeah I was on the pill all my life so little hope for me..
Me too. I lived through many cancer scares of all sorts, starting with the one where it gave you all female cancers, and you needed a full internal before you could take it :-\ (it actually protects against some of them now ::) )
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While this publication provides important information, limitations do exist in relation to types of studies reviewed (with 43,022 cases from the much criticised Million Women study), and absence of data on mortality associated with breast cancer; previously reported randomised trials showing no significant difference in cancer deaths from women who took HRT compared to placebo.
From Dr Currie's reply.
It sounds like the Million Women Study skews results, as it was such a large study. It was an self-selected observational study which found correlations that require further study, rather than any cause and effect (which would need a series of proper random control trials to get any where near to proving).
I think that the MWS was Valerie beral's life work and she is going to promote it for ever.
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Good article Westie, puts it in perspective x
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This is a response to today's report from Dr Louise Newson
https://www.menopausedoctor.co.uk/news/sensationalised-report-on-increased-breast-cancer-risk-concentrates-on-older-hrt-ignores-proven-benefits
W xx
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Hi Ladies
I know you can't reassure me because the study is the study but my health anxiety is going through the roof! I take Estrogel 3 umps and have a Mirena coil. I've have a Mirena for years due to heavy periods then started the Estrogel 18 months ago to help with my awful anxiety and low mood, the HRT has really helped my anxiety, I cant take AD's as had a really bad reaction to the ones I tried so going back on them is not an option for me.
I'm so scared about this new study I just don't know what to do.
I am 54 and have had a terrible time the last coupe of years and just cant face going back into hell if I stop the HRT. My husband says to discuss it with my Gynecologist when I see him next month.
I am not overweight, I don't drink and I stopped smoking 3 years ago although I do still smoke a vape.
Do you all think we should stop using it?
Jeana
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Professor Studds comments taken from the online version of The Times
Transdermal oestrogens , gels patches or implants with minimal progesterone (not synthetic progestogen ) is very safe and beneficial
Be careful of these controversial studies announced at a press conference on Wednesday , embargoed until publication on the Friday. It then becomes front page news before the scientific community have been able to study the complex data The same Oxford group played the same trick 10 years ago with their flawed Million Women Study and the discredited and harmful WHI study
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Thank you for posting the links Emma & Westie. The breast surgeon's views are pretty much those I have encountered in past discussion with other breast health professionals, including 3 oncoplastic surgeons.
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Professor Studds comments taken from the online version of The Times
Transdermal oestrogens , gels patches or implants with minimal progesterone (not synthetic progestogen ) is very safe and beneficial
Be careful of these controversial studies announced at a press conference on Wednesday , embargoed until publication on the Friday. It then becomes front page news before the scientific community have been able to study the complex data The same Oxford group played the same trick 10 years ago with their flawed Million Women Study and the discredited and harmful WHI study
Does this mean that the Mirena and Estrogel combo is a higher risk?
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A snapshot of a randomised 'general public' response in the form of my husband who earlier sauntered through in dressing gown and remarked,
'they're talking about progesterone on the radio and it sounds very serious, they say it increases the chance of breast cancer by 50%. They sound like they know what they're talking about.'
Once again HRT studies hit the news, the headlines shock, shudder and have a direct deleterious affect on societies' perception of HRT losing sight of all the proven positives it has on womens' health, well being and quality of life.
🐾C
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Jeana1...I don't think so because the amount of progesterone in the Mirena is minimal x
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I wish they've made their mind up!
One day hrt is the only thing, the other it causes cancer!
...enough to give us serious flash! ;)
To me this article was that journalist's opinion!
The research itself starts from a statement:
Published findings on breast cancer risk associated with different types of menopausal hormone therapy (MHT) are inconsistent, with limited information on long-term effects. '.
So why such a headline?!! ...
This is an analysis of published between 1992-2019 (?) articles!
This is not a new research! ..just a mince of what was said so far, and we all know well how much rubbish was said to date.
It's like being back to dark ages, though!
Scandalous treatment of older women, that's all.
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Your risk of BC is still higher than HRT if you are overweight or drink alcohol, i will keep taking the HRT as long as i can still get my hands on it!
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Jeana1...I don't think so because the amount of progesterone in the Mirena is minimal x
Hi Dotty
I am maybe over panicking but my anxiety is through the roof!! I just can't get my head around it all, I've read the paper on it but still don't really understand the increased risk, is it 2 extra women is it 10 is it more!!! It's complicated :'(
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Your risk of BC is still higher than HRT if you are overweight or drink alcohol, i will keep taking the HRT as long as i can still get my hands on it!
This made me feel a bit calmer...............thank you
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I would rather take HRT if it improved anxiety and depression than the anti depressants that some doctors want to dish out. My MIL was on medication for depression for 30 years, she developed dementia and the tablets she was on is reported to increase dementia risk.
Please note i am not knocking anyone who needs to take anti depressants as i know they are a life saver, my son had to take them for a year.
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Damn right!
..just tell all men to keep their hands off your breasts and all be fine! :o
(don't kill me for this joke but, this headline today made me really mad!)
Do not panic Ladies!
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Jeana1
From cancer research
2% BC from post meno hormones
8% BC obesity
8% BC alcohol
Using HRT has meant that i can exercise, i need systemic for VA, that helps me keep my weight down.
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Hi Tinkerbell
Thank you for that. I suppose there will be a lot of ladies out there really worried like me and not sure what to do, it's like I start to get my life back on track then get hit with this study today. it knocks the wind out of me.
Will be keeping an eye on posts all day!!
Jeana
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Jeana1
From cancer research
2% BC from post meno hormones
8% BC obesity
8% BC alcohol
Using HRT has meant that i can exercise, i need systemic for VA, that helps me keep my weight down.
Exactly. Xx
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Hi Jeana1- based on their research of previous trials it's estimated to be an extra 2 in every 100 of HRT taking ladies. However, some of the previous research was old , discredited and covered older types of HRT . They reckon the risk of breast cancer is higher if synthetic progesterone is used ( mainly ) on a continuous basis and less so on a sequential regime. There is very little evidence of studies based on micronised progesterone being taken into account.
Lifestyle factors such as drinking, smoking and obesity carry a much higher risk of increased cancers so I think there is some headline grabbing scaremongering going on here albeit there may be a grain of truth in the statistics. I'd keep on taking it until more information comes to light and you can then revisit your decision.
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Hi Jeana1- based on their research of previous trials it's estimated to be an extra 2 in every 100 of HRT taking ladies. However, some of the previous research was old , discredited and covered older types of HRT . They reckon the risk of breast cancer is higher if synthetic progesterone is used ( mainly ) on a continuous basis and less so on a sequential regime. There is very little evidence of studies based on micronised progesterone being taken into account.
Lifestyle factors such as drinking, smoking and obesity carry a much higher risk of increased cancers so I think there is some headline grabbing scaremongering going on here albeit there may be a grain of truth in the statistics. I'd keep on taking it until more information comes to light and you can then revisit your decision.
Hello MicheleMaBelle
Thank you for your message, I think that I react so badly because of the anxiety and health anxiety (it's a mean beast!) both have greatly improved since taking HRT, I suppose my worry is that the Mirena is continuous and then with the added 3 pumps of Estrogel too its a lot of HRT. I see the gynae next month so will discuss it with him, in the mean time I think I have to "man up" and get on with it and get things under control in my head!
Jeana
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Yes, Birdy, it came to mine!
... getting rid of by saving on post-procreative women... ? ...cutting our pensions as well..!
In Africa, apparently, they take them to the bush and leave there... as the Red Nose charity once discovered ..and built them a camp..
For some time now, I see that Meno issues more as a social issue, even political, than a medical one. Eh :o
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I haven't read the entire thread – but has anyone acknowledged how the release of that article about HRT being highly toxic coincides neatly with the current HRT shortages?
I don't think anything in the research says HRT is highly toxic. It just says there is a small increased risk that women should be aware of. As for the shortages, as I have said before, lots of other meds are short too. Anything to do with a 'No Deal Brexit' stockpiling????
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I agree!
..and only few days after few positive ones, in the same Guardian..
This headline today got me flying! You can see yourself, here, how much anxiety it caused.
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Shadyglade, this shortage is of Evorel only, because its producer did not plan accurately for, apoarently, increased demand and one component was not ordered therefore produced on time. They said that it will get back to normal only by mid next year.
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Shadyglade, this shortage is of Evorel only, because its producer did not plan accurately for, apoarently, increased demand and one component was not ordered therefore produced on time. They said that it will get back to normal only by mid next year.
Well there you are. No dastardly plan to stop women having HRT.
I think you have to put the study into context. All medication comes with adverse effects and this research is just making those risks clear. It's up to individual women to balance the risk against benefits.
Why the panic.
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I like your positive thinking Shadyglade!
Well, today's findings are by exactly the same Oxford group who published that flawed research in 2002 after which so many women got off HRT, and suffered in silence since...
It seems that sales picked up recently, more women are on it again.
These drugs are not cheap!
Most are prescribed, meaning increased cost to NHS.
...
Whom better to save monies on if not on older women ...who can't procreate any more, useless.. ? In short, conservatives are in action!
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Is it the same group??
I don't remember seeing that. Where will I find the info?
Thanks
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Shadyglade, in this very thead!
..someone quoted Prof Studds.
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Shadyglade, in this very thead!
..someone quoted Prof Studds.
Okay, if the research is rubbish my same question is why panic.
Isn't the said Professor a private consultant. No conflict of interest then!!
Doesn't the post by Dr. Currie put it into perspective??
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So this is what everyone is saying, including myself.
Don't panick!
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Shadyglade, in this very thead!
..someone quoted Prof Studds.
Okay, if the research is rubbish my same question is why panic.
Isn't the said Professor a private consultant. No conflict of interest then!!
Doesn't the post by Dr. Currie put it into perspective??
As any news editor will know too well, that article will cause widespread panic. Look at the reactions on this forum today. As soon as anyone says there is a definite link between HRT use and breast cancer, anxiety will ensue.
Not everyone knows that the findings need to be pulled apart and examined precisely to understand that alcohol use and obesity are bigger cancer risk factors. Newspapers and news stories in the media spread fear very efficiently – the headline alone does just that.
Does that mean you would rather not know??
Ignore the article and read the research paper.
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I'm lucky in that I don't take any prescription medication. However, if I did I would want all the information I could get. But having said that this research shows an increased risk of 1 per 50 woman as a worse case sinario. So if you balance that with the benefits I would say it is of concideration but not panic.
Nothing else I can say really.
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Just for clarification the Women's Health Initiative is based in US and it was that group that carried out the controversial HRT trials, the results of which led to much of the current (mis)information on the effect of HRT and cancer risk. It was this particularly which was discredited for a number of reasons, but because it was a randomised controlled trial it was originally given a lot of credence. The Oxford Group carried out the Million Women Study - I don't know much about this but was an long-term observational study just using questionnaires I think, not a trial, but also published around the same time. Information is still being collected. Because it is not a trial then again no definite conclusions about cause and effect can be drawn even though data are interesting.
Also re the timing - I agree it is very unfortunate and likely to scare a lot of women into stopping HRT at a time when it's difficult to get hold of. However it takes some time for a paper to be published from the time of submission as it has to be peer-reviewed. Having looked at the Lancet website this morning there can be a fast-track process where a paper can be reviewed and published within 4 weeks so if this process was followed for this paper then it presumably was submitted a month ago - possibly before the recent headlines about HRT shortages?
Like someone said earlier in the thread, my husband also was expressing sympathy towards me as he brought me my morning cuppa having heard the headlines this morning, saying I might get breast cancer (which I might anyway), and he's a scientist. After I explained to him in a befuddled half awake state after looking briefly at the Lancet paper he understood what I was getting at.
Yes Mirena does provide continuous progestogen at approx the same rate probably as a Femseven patch but probably less than tablet HRT. However in the short term I really wouldn't worry and as others have said - get slim, take exercise, eat well, stop smoking, cut the booze and you will at least be able to take HRT knowing you are minimising other risks and protecting yourself from other long term conditions.
I shall continue to use my oestrogen patch and bio-identical progesterone taken on a long cycle (ie minimising the progesterone), and be vigilant about any adverse symptoms or unexpected bleeding.
Rock and a hard place come to mind as we contemplate living into our 90's - the lucky ones.
Hurdity x
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My cynical side suspects that our attention has been drawn to this new study now because of the shortages of patches! :( On the FB VA group, others have suggested exactly the same. They got there before I did. I have just been to the GP for something unrelated but couldn't resist the chance to ask about an alternative to Evorel Conti if I can't get more until next year. (no answer given) and then suggest this.
GP looked slightly surprised but didn't say anything to reject my suggestion.
I'd like to hear what the author of "Oestrogen Matters" thinks of this latest study.
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I was trying not to be cynical Katejo but it is difficult in the circumstances!! The press love a sensational headline don't they?
Hurdity x
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Well said Hurdity.
We all know HRT carries a degree of risk, it might turn out that the risk is now greater ( but still small ) or just the same and that we can minimise risk by making good lifestyle choices.
I'm going to stay on mine for the time being but thinking of coming off it after my holiday and this has absolutely nothing to do with this latest scare.
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Whichever was first Hurdity, it is us older women who are being hit!... again.
Think of all 45+ walking into Meno blind unaware of what's ahead, and who saw today's headline!
I have enough of Evorel Conti till end of January. I can only pray they'll sort the issue by that time, and sympathise with all who are going through difficulties right now.
Articles like today's one do not help!
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Well said Hurdity.
We all know HRT carries a degree of risk, it might turn out that the risk is now greater ( but still small ) or just the same and that we can minimise risk by making good lifestyle choices.
I'm going to stay on mine for the time being but thinking of coming off it after my holiday and this has absolutely nothing to do with this latest scare.
I want to stay on the patches for now to give time to get the full benefit. They are possibly starting to relieve the tight muscles in my calves/feet and I want to see if that continues or not. I only noticed a slight improvement this week so I am not sure yet. The study does say that the risk may not be increased if the HRT has been used for under a year and I only started full patches in July.
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Well said Hurdity.
This whole sorry business gives me a sense of deja vu, from when my oestrogen only HRT was stopped by a GP in 2003, after the publicity originally given to the WHI and Million Women Studies. Hopefully today's middle aged and older women will be better educated about the menopause and about what to do if given similar poor treatment.
None of the organisations and individual experts who have responded to the meta analysis seem to think it has advanced our knowledge at all, or have I missed something? At any rate, we won't let it distract us from the alarming shortage of HRT products, which is of much greater concern.
JP x
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The following response from Louise Newsom is more positive/offers some reassurance. https://www.newsonhealth.co.uk/news/sensationalised-report-on-increased-breast-cancer-risk-concentrates-on-older-hrt-ignores-proven-benefits?fbclid=IwAR1KQeuOIAu-mcNz7pu1EJPVsebgkNzy35HqU0s4u5TRtLQpaUGh28jJJQw
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Hello ladies.
I am not an expert on the science but we all know that HRT carries a small risk of cancer, it's a question of risk management, surely.
If we need HRT to have any quality of life perhaps we can lower our overall cancer risk by not smoking and drinking and not being obese. I believe we still have a lot of control over our health and I take comfort from that.
Wishing everyone well.
K.
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These studies shake out and affect the views of the wider public, that is one thing, what worries me ( and causes me considerable anxiety) is the affects on GP's who act as our gatekeepers. I
make an informed choice to take HRT. I also take exercise, don't smoke, try to be healthy. I pay for my hormones. I think it should be every woman's choice to weigh up her circumstances and it should not be up to others to decide for her.
My Mum had many happy years on HRT before that last big American scare directly affected the women of her generation and she was more or less frogmarched off hormones by new skewed directives given to NHS GP's whom she trusted.
I do not want the same to happen again to this generation and it fills me with fear.
🐾C
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Hi Ladies
I emailed Dr Karen Morton (consultant gynecologist) this morning about the HRT study and told her I was very worried about it, here is the reply she sent me.
Dear Jeana, I am sure you are not the only woman who listened to the Radio 4 broadcast with anxiety. I sometimes wonder what the press would do without these sort of studies to raise alarm about. I inset here the response that a colleague of mine, Dr Peter Greenhouse has written to the Editor of the programme wishing that the whole picture was better portrayed. 'To the Editor I hope you will have someone authoritative speaking in response to Prof Val Beral's Lancet study. Nobody should alter their HRT regime or consider not starting HRT because of this research because: 1. Women who take HRT are less likely to DIE of breast cancer than those who've never taken it 2. Women who take HRT and do develop breast cancer have a significantly better 10 year survival (80%) than those who've never taken it (64%) 3. Women who take HRT have a lower all-cause mortality than those who've never taken it - due mostly to a substantially reduced risk of death from heart attack 4. The risks of being denied HRT far outweigh any from taking it, as there is a “Mortality Toll†from HRT avoidance These four simple messages should be offered to the public with equal emphasis to the information from the Oxford group Lancet study.' So Jeana, I hope that reassures you. I do not think you should change anything, but of course, like all women, be vigilant about self examination and having your regular mammograms. Very best wishes, Karen
Jeana
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Thanks!
Yeah, I can sense a storm coming.. :-* The Guardian took it off their front page, and on radio they added a message from doctors to not panick!
We are in the news! 8)
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Hi Orrla
Just seen a tweet from Dr Peter Greenhouse , I think there is going to be some backlash from this study!
Feel a bit calmer now but it really did ramp up my anxiety and probably many many more ladies have had a bad day too due to this!
Jeana
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That's why my GP said "no way" to the patch...not only due to age (68 years young) but my mom and all 3 aunts has breast cancer. She is a meno GP and attends several conventions a year on a wide range of menopausal topics. She said any woman who has a direct relative with breast cancer must be diligent when using HRT. Who knows for sure if it does or doesn't. Quality of Life versus Quantity of Life. When the Grim Reaper comes calling it doesn't care if you used HRT or not.
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Well, I like this summary:
1. Women who take HRT are less likely to DIE of breast cancer than those who've never taken it
2. Women who take HRT and do develop breast cancer have a significantly better 10 year survival (80%) than those who've never taken it (64%)
3. Women who take HRT have a lower all-cause mortality than those who've never taken it - due mostly to a substantially reduced risk of death from heart attack
4. The risks of being denied HRT far outweigh any from taking it, as there is a “Mortality Toll†from HRT avoidance
When I was deciding to go on HRT, which we all know that is not perfect, only one thing was known for sure, that it protects against Osteoporosis. My Grandma spent her last 5 years in bed with broken bones that could not be put back together from it, so genetically I am prone, hence my decision. I am 19 years on it, and intend to continue!
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Wearing my cynical hat, we had Dame Valerie on R4, the day before the new NICE menopause guidelines, telling everyone that HRT definitely gave you breast cancer - could probably search for it on the threads if I had time ::)
They are very intransigent about that Million Women study, and willing to scare women. I would be more inclined to listen if the new study had been presented to all the other researchers in the field at conference and properly mulled over.
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Been out all day so first chance to comment on all this but been angry since I read the headlines in The Times. The press must be rubbing their hands in glee to get Boris off the front page! Yup call me cynical but there's a certain amount of ‘bad news spin' associated with this IMO.
Yes research is good, but I read it as 93.7% of women who have never taken HRT won't get breast cancer over the 20yrs from the ages of 50-69yrs and 91.7% of women's who have taken HRT won't get breast cancer over the 20yrs from the ages of 50-69yrs.
But, and this is the big thing, all those women in the ‘study' weren't identical. We're looking at different lives led from conception to age 50+, different environments, different lifestyles, different genes, different risks. Until science can give us each an individual risk level, based on just you there's a lot of assumptions being made. Maybe those living in urban areas with high pollution are more at risk? But of course they are looking for a ‘common factor' that could possibly link that 2% increase but what if it's not HRT?
For those who suffer from health anxiety headlines like this are just irresponsible.....lazy reporting IMO. I'm guessing Rosie Taylor who wrote the article in The Times isn't menopausal yet or she might have spent more time researching the report and presented it in a less 'tabloid' manner. 😡
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Well said sooze. Again QUALITY versus QUANTITY. My mom and her 3 sisters all had breast cancer. My mom and 1 Aunt died due to cancer. None of them took HRT. Genes play a much more important role in MHO along with stress, environmental conditions, shift work, etc., etc., etc. If you have the BRCA1 and BRCA 2 gene then maybe HRT 'might' exacerbate these genes but in life everything is a crap shoot.
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Hi Ladies, Just catching up on all the comments & links, thanks everyone. x
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I feel incredibly cynical about the timing of this report with regards to the shortages. It's really irresponsible to say all that stuff but not put it into a more balanced perspective.
I really hope women will be able to see through it. We aren't stupid, we already know there is a risk, 1 in 8 of us will get it anyway, hrt or not. What about the £1billion Nhs spend on hip fractures etc! I'm actually more worried about osteoporosis and heart disease if not taking it than the breast cancer as there is a higher risk.
If hrt is good enough for Dr Newson it's good enough for me! X
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Katejo
I'd like to hear what the author of "Oestrogen Matters" thinks of this latest study
. I said the same thing to OH this morning.
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Jeana, thank you for posting the statement from Peter Greenhouse.
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Now that you mentioned him...
Reduced risk of breast cancer mortality in women using postmenopausal hormone therapy: a Finnish nationwide comparative study
https://www.ncbi.nlm.nih.gov/pubmed/27465718
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For those just starting out on the meno phase or trying to decide what to do, I guess it’s a case of seeing how bad the symptoms are and whether you can cope with them or not.
If you feel you can’t cope with them ( if you have them), then maybe try hrt for as short a time as possible.
When I first saw my GP about it, she said she recommends to ladies who are starting with some bad symptoms, to try it for as short a time as possible. Eg 6 months to a year and then come off it to see if the symptoms have passed. X
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What grinds my gears is the sensationalism around the study findings, and how it's shoved in every paper article and news channel.
Even though they say the risk has doubled it's still half the amount that is associated with alcohol and obesity, yet you never see news items dedicated to these topics in the media on how alcohol and obesity have the greater adverse effect on BC, bexause that doesn't fly with ppl.
I think it is good to have the research, just not a fan of the media revelling in it.
Botton line is if you decide to continue taking hrt be on top of breast checks, mammograms etc, you can pay £50 and have it done through the nhs in the gap between the existing 3 year national screening program. And stay on top of how much alcohol you drink and what you eat.
TD
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Apologies if this has already been posted.
https://twitter.com/mymenopausedr/status/1167487284381409286's=21
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Morning Ladies!
What a morning! Let's not panic!
This is worth a read
https://www.dailymail.co.uk/debate/article-7409263/Yes-cancer-risks-Id-prescribe-HRT-writes-breast-surgeon-PROF-KEFAH-MOKBEL.html
W xx
That is an excellent sensible article!
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I haven't read all your responses but I stick to Quality of Life. That bus might be along B4 breast cancer symptoms appear or another disease might carry us off!
No one has asked me and I had treatment in the 1990s. I have never been checked since being discharged 3 years after surgery. It wouldn't cross my mind not to take HRT if symptoms were so bad that I considered suicide. I haven't read the articles : but have any followed actual patients, i.e. lifestyle, drink/drugs, obesity ........ or has this been done via medical records? Also, what's the magic 10 years after stopping HRT ....... anyone who stops and begins HRT knows that sometimes symptoms return with a vengeance. So if the hormone upheaval has settled within that 10 years so that a lady doesn't require treatment, what else would be triggering breast disease?
Cherry picking! A Gynaecologist was interviewed on the BBC and I remember her saying "When a woman has been through the menopause she may require treatment" ......... :-\ ::) it was someone that the BBC had got hold of, rather than asking a professional who is dealing with menopause as their job ...........
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Does this research also include local HRT for atrophy?
After reading the results I'm more concerned now about the 8% for obesity and drinking.
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Response from Louise Newson in this morning's Telegraph
https://www.google.co.uk/amp/s/www.telegraph.co.uk/health-fitness/body/doctor-menopause-specialist-sticking-hrt/amp/
It concerns me ( and makes me quite mad actually) that the many benefits of HRT which can literally save lives, never seem to make the headlines.
W
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Good point Countrygirl! Westie & CLKD I agree, quality of life for me is what's important after 3+ horrendous yrs of symptoms/torture. I'm aware of the risks & did due diligence before starting HRT also doing things to reduce my risk ie weight loss, change of diet, increased exercise etc. x
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Hi, lots of counter-argument stuff on Dr Newson's website this morning:
https://www.menopausedoctor.co.uk/news (https://www.menopausedoctor.co.uk/news)
On the plus side this has given some much needed prime time national coverage about meno and hrt which might kick off some further debate higher up for better women's health care and gp training (we can but hope). X
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Dierdre - I believe the meta-analysis reported yesterday found that topical use (Vagifem/Estriol/Ovestin) seems to carry no additional BC risk.
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Absolurely!
To everyone's horror, I bang on Menopause daily, whenever I remember, ever since I learnt what a taboo it is.
It makes me mad still that I walked on it without a clue what to expect.
If I knew I would plan for it!
It cost me over 10 years of earnings, most relationships, and a lifestyle that was impossible to continue with all the shitty symptoms that I had, with no understanding from anyone around.
Past week's articles in the Guardian were posted by me everywhere!
Because it was that reluctance to talk about it, that shame that is still attached to Meno, that did all that.
3/4 of what I got did not have to be! Medical aside, various people's attitudes make things far far worse.
So yes, it is good that there it was so much info on front pages. By the way, I wish they stopped listing that vaginal dryness not all have but provokes stupid jokes, and low libido (mine went through the roof), but otherwise many many good points were made, including about work.
I remember very well how I wished I could work flexible hours, or work from home, ... as Labour market and Meno are not compatible still at all...
...and women are underinformed, GPs too, and all is in its infancy still, so I can't get it why on earth anyone wanted to publish on the front pages of the major press such a scare title yesterday?!!?
..some fight between pro-choicers and pro-lifers, like with abortion.. with women caught up in between..?!?
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Brilliant points made Orrla,
I too would've altered my last decade had I known what was going to come...but sigh, there is no point in me regretting..
To focus upon work and the effect that menopause has on that- a serious point.
I thought I would skit off from your post and open a new thread on this subject...
🐾C
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Thanks, Callisto!
Meno and Work is only mentioned recently, since that Meno week BBC 4 Women's Hour did two years ago...
It needs to be talked about, for, completely different are experiences of housewife living with high earner loving husband and that of single women earning for her living.
I wish women themselves understood this! ... and stop telling me that they sailed through it.. and Black Cohosh helped them!
Even if my vagina was dry this would be my least concern.
My pension was greatest!
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Thanks, Callisto!
Meno and Work is only mentioned recently, since that Meno week BBC 4 Women's Hour did two years ago...
It needs to be talked about, for, completely different are experiences of housewife living with high earner loving husband and that of single women earning for her living.
I wish women themselves understood this! ... and stop telling me that they sailed through it.. and Black Cohosh helped them!
Even if my vagina was dry this would be my least concern.
My pension was greatest!
Here we go again ::)
There are many women who CAN'T or just don't want to take HRT. Please don't criticise them for using Alternatives.
I was once told on this very forum that 'you can't possibly have suffered or you would have used HRT'
Well excuse me nobody has the right to judge others meno journey. >:(
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Thanks Wrensong, just need to loose weight and stop drinking then as this seems to be more risky than HRT.
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Havnt time to read all of this as at work, min wage, heavy lifting, long hours on my feet. Depression in the morning if i dont run, harder if i do, as tired quicker. Like a zombie at night unless i rely on a cocktail of vit B, ginseng and co enzyme q10. All in a day. Stopped hrt yesterday thanks to all the press. Was told originally it was safe after years of it being incorrectly being viewed as unsafe. Now its unsafe again. All the people i know who have had cancer , have died. I have no option but to stop , although both female realtives had heart conditions. Would be as well playing Russia roulette. Think all the talk of "lets talk about menopause" is lipservice. It always involves employers being told i need rest rooms and fans etc. A fat lot of use on a long shift when fatigue is your biggest problem. Yes i agree with one comment , its all about bloody vaginal dryness. Who cares, some of us have to work to 67 in limited jobs because we cant think well enough with un effective medication, to be able to even get training or study (anymore). No wonder we are depressed, its a vicious cycle. And what do they hand you? A little card to find Menopause matters website where "all your questions will be answered " because as a doctor, i havnt the time/energy/enthusiasm or knowledge to answer. So all go chat n cry n moan to each other which helps none of us ut at least youre all in one place where youre seen and not heard til its time to go to work. Yes im pissed off. Ive written on this column because i wanted to truly express my empathy to the originator of this discussion (and others who echo it) im sorry but its way more than hot flushes and much needs to be changed in the wzy its being "talked about" 😡
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..where exactly did you see a judgement?
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..where exactly did you see a judgement?
Mocking use of Alternatives. That's not no.
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Hello Sickntired!
...like you nick ;)
I sympathise with you, I know what and how you feel!
The point in talking about Meno widely is for deciding bodies to finally do something about it, issue policies, provoke change in attitudes.
If all pretend that nothing happens, and Black Cohosh is enough, no one will invest any monies in complicated research and development of appropriate medication that would help women continue with lifestyles they chose, or must be in like you and me ..
After that scare in 2003 women stoped complaining to their GPs in search for medication. The effect was that GPs did not educate themselves enough!
The more of us complain the more pressure will be on deciding bodies to do something constructive about it!!!!
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Yes Birdy!
And why is this????!!!
Perhaps, because no one noticed that she needs more than fan and Black Cohosh, because of so many claims that as it is a natural stage of life, women need to just get on with it..?!
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Thanks, Callisto!
Meno and Work is only mentioned recently, since that Meno week BBC 4 Women's Hour did two years ago...
It needs to be talked about, for, completely different are experiences of housewife living with high earner loving husband and that of single women earning for her living.
I wish women themselves understood this! ... and stop telling me that they sailed through it.. and Black Cohosh helped them!
Even if my vagina was dry this would be my least concern.
My pension was greatest!
Here we go again ::)
There are many women who CAN'T or just don't want to take HRT. Please don't criticise them for using Alternatives.
I was once told on this very forum that 'you can't possibly have suffered or you would have used HRT'
Well excuse me nobody has the right to judge others meno journey. >:(
..where exactly did you see a judgement?
Mocking use of Alternatives. That's not no.
I have not detected any mocking whatsoever! Orrla is making good points about the way women are treated and also about the attitudes of some women who have chosen not to take hRT because they do not experience debilitating symptoms, seeing women who do so as weak.
I for one am actually pleased I did have severe symptoms that prevneted me functioning normally because I then "resorted" to HRT after "failing" with Black Cohosh (which I took for some time) and phyto-oestrogen diet - and at least now I have had a number of years of protection especially against osteoporosis which is in my family.
Hurdity x
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Thanks, Callisto!
Meno and Work is only mentioned recently, since that Meno week BBC 4 Women's Hour did two years ago...
It needs to be talked about, for, completely different are experiences of housewife living with high earner loving husband and that of single women earning for her living.
I wish women themselves understood this! ... and stop telling me that they sailed through it.. and Black Cohosh helped them!
Even if my vagina was dry this would be my least concern.
My pension was greatest!
Here we go again ::)
There are many women who CAN'T or just don't want to take HRT. Please don't criticise them for using Alternatives.
I was once told on this very forum that 'you can't possibly have suffered or you would have used HRT'
Well excuse me nobody has the right to judge others meno journey. >:(
..where exactly did you see a judgement?
Mocking use of Alternatives. That's not no.
I have not detected any mocking whatsoever! Orrla is making good points about the way women are treated and also about the attitudes of some women who have chosen not to take hRT because they do not experience debilitating symptoms, seeing women who do so as weak.
I for one am actually pleased I did have severe symptoms that prevneted me functioning normally because I then "resorted" to HRT after "failing" with Black Cohosh (which I took for some time) and phyto-oestrogen diet - and at least now I have had a number of years of protection especially against osteoporosis which is in my family.
Hurdity x
Well I certainly did detect Mocking and I stand by it. And how do you know what women have experienced that don't take HRT, the assumption that they can't have had a bad meno is insulting and astonishing.
This forum is not just for women on HRT.
Or is it??
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Havnt time to read all of this as at work, min wage, heavy lifting, long hours on my feet. Depression in the morning if i dont run, harder if i do, as tired quicker. Like a zombie at night unless i rely on a cocktail of vit B, ginseng and co enzyme q10. All in a day. Stopped hrt yesterday thanks to all the press. Was told originally it was safe after years of it being incorrectly being viewed as unsafe. Now its unsafe again. All the people i know who have had cancer , have died. I have no option but to stop , although both female realtives had heart conditions. Would be as well playing Russia roulette. Think all the talk of "lets talk about menopause" is lipservice. It always involves employers being told i need rest rooms and fans etc. A fat lot of use on a long shift when fatigue is your biggest problem. Yes i agree with one comment , its all about bloody vaginal dryness. Who cares, some of us have to work to 67 in limited jobs because we cant think well enough with un effective medication, to be able to even get training or study (anymore). No wonder we are depressed, its a vicious cycle. And what do they hand you? A little card to find Menopause matters website where "all your questions will be answered " because as a doctor, i havnt the time/energy/enthusiasm or knowledge to answer. So all go chat n cry n moan to each other which helps none of us ut at least youre all in one place where youre seen and not heard til its time to go to work. Yes im pissed off. Ive written on this column because i wanted to truly express my empathy to the originator of this discussion (and others who echo it) im sorry but its way more than hot flushes and much needs to be changed in the wzy its being "talked about" 😡
So sorry to read you feel like this and I know you have no time to read the thread and all the responses by eminent scientists and gynaecologists to the sensational press headline yesterday - but this latest research does not mean you have to give up HRT. It is all sensationalised and no further causal relationship between HRT and breast cancer has been established. The research just reanalysed a whole lot of data and lumped it together with a very complicated statistical analysis to come up with some figures about risk.
The general consensus is that the possible increased risk of breast cancer from HRT varies according to the type of HRT - with transdermal (through thr skin) bio-identical hormones (estradiol and progesterone - as widely available from GP) being safer than synthetic alternatives. Also that lifestyle measures can carry gretaer risk ie being fat, (fatter than optimal), unfit and drinking too much so having a good diet full of fresh ingredients, reducing alcohol, taking exercise, maintaining or achieving healthy BMI, will mean you minimise your cancer risk from these, even if you have a marginally increased risk from taking HRT. The absolute risk in any case is small.
Also that there are many health benefits from HRT which can protect you from many other conditions and also some cancers so it is a balance between risks and benefits that need to be considered.
Please do not give up your HRT in a hurry. If you have certain risk factors eg re heart disease ( do you?) these can be mitigated through lifestyle measures and the type of HRT.
Heavens we can all do without this (press headlines) at a time when we are living 30-40 years beyond menopause if we're lucky!
Hurdity x
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Note I used the word "some" - and I know this because of many accounts I have read in the press and on various forums over the years including this one.
Hurdity x
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I didn't see any mocking either! Can we please not bloody well fall out.
Quite so Birdy :) !!!
Hurdity x
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Shadyglade, don't take it personally! This is about a big picture, not you!
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So anyone:
If a lady stops HRT for what ever reasons, why does she very often have dreadful symptoms: for which she took the product in the first instance? Often within a matter of days, those symptoms return. So how does anyone reach the conclusion that cancer risks remains for X, Y, Z years after stopping it?
Does this mean that during our productive lives, women are at high risk of cancer developing due to our own hormones? Mine lump was found to have changes at the margins and apparently oestrogen caused. But how many women do not develop cancer through their productive lives :-\. All this topic has caused 4 me is more confusion :D.
I would have to deep think as to where I was in relation to my cycles and what age I was when I had surgery. Too tired right now ::)
Not one of my surgical team has contacted me over the years to see how I've fared once I reached menopause ........ I was never asked to let the surgeonor or oncologist know so there's a whole raft of patients out there that are never talked to :-\. no joined up thinking? Again!
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I do think there has been a lot of pressure with menopause atm. Weather you can't get what you need or we should not be talking it ect.
I've always seen things if someone has something that bothers them it's a problem no matter how small compared to your own problems.
And at times like this we all need to support one another. 😘
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The reason why I take HRT is because I was diagnosed with osteoporosis at the age of 53. The problem I have with media articles on the menopause and HRT is this emphasis on hot flushes and vague mood swings, as if that's all the menopause is. Other than a passing comment on osteoporosis risks in the last paragraphs of these press articles, I haven't seen anything about the risks of fractures and falls and the associated mortality risks of osteoporosis. I wouldn't have even known I had osteoporosis had I not had a DEXA scan and those are not given routinely.
For the individual, it's all about the relative risks. I have to weigh up the risks of HRT against the risks associated with osteoporosis first and foremost. Other people have other risks to weigh up. Also, there's no such thing as zero risk for anything. It's not as if we can stop HRT and become risk free. Besides we should all be having our weight and BP measured at our HRT review appointments, and keeping up with our NHS health checks and screening appointments. We all know that we need to be sensible about alcohol consumption. When we are prescribed HRT we are informed of the risks. We make an informed decision. My decision was about protecting my bones. There's no right or wrong. We do what we feel is right for us.
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The reason why I take HRT is because I was diagnosed with osteoporosis at the age of 53. The problem I have with media articles on the menopause and HRT is this emphasis on hot flushes and vague mood swings, as if that's all the menopause is. Other than a passing comment on osteoporosis risks in the last paragraphs of these press articles, I haven't seen anything about the risks of fractures and falls and the associated mortality risks of osteoporosis. I wouldn't have even known I had osteoporosis had I not had a DEXA scan and those are not given routinely.
For the individual, it's all about the relative risks. I have to weigh up the risks of HRT against the risks associated with osteoporosis first and foremost. Other people have other risks to weigh up. Also, there's no such thing as zero risk for anything. It's not as if we can stop HRT and become risk free. Besides we should all be having our weight and BP measured at our HRT review appointments, and keeping up with our NHS health checks and screening appointments. We all know that we need to be sensible about alcohol consumption. When we are prescribed HRT we are informed of the risks. We make an informed decision. My decision was about protecting my bones. There's no right or wrong. We do what we feel is right for us.
Exactly anais. I agree with you 100%.
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Good point CLKD. I think quite likely there are some of us who's own hormones cause BC. The majority of BC's are estrogen receptive. My family history is exactly that, so, already at a higher risk, it would not be right to add to that risk with hrt, as far as I believe and from what my gp has said.
I think it's really important for each individual woman to read the risks on the small print of whichever hrt they are taking. Whatever is listed is there for a reason, even if the ‘specialists' tend to brush that off or maybe don't even bring them up.
It's also true regarding weight and alcohol. I think we all need to try our best to be in the middle of our own bmi recommended number and not to drink more than the recommended 14 units of alcohol per week.
I've noticed that when I'm lighter in weight, my flushes/sweats are much reduced.
I also really feel, from reading many posts on here, that many women feel scared to come off their hrt, but I'm wondering if they have tried, because it's important to also remember that everyone is different and symptoms may well have passed for some and therefore no need to take it anymore.
I had a bone scan recently as I do not take hrt, so wanted to check my bone health. I will have one every two years to stay on top of potential osteopenia. X
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Have you had the bone scan result?
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No I haven't had the result yet, they said two weeks, which will be Monday, so I will call my gp on Monday. I'm very interested to know what my level is as I don't take hrt. X
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Jari I have osteopenia do you? Can you reverse it do you know? Xx
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It's a shame people start falling out over taking/not taking HRT. All we can do is make an informed decision. It's about the relative risks. There's no such thing as no risk, regardless of what decision we make.
I was diagnosed with osteoporosis at 53. I had not taken HRT at all at that point. I already had reached the diagnostic threshold right at the natural menopause. There's no “reducing the risk of osteoporosis†benefit for me. I already have it. The thing is, I had been aware that we need to look after our bones years before the menopause and I honestly didn't expect to be diagnosed with osteoporosis. My gynaecologist said that if my ‘menopause symptoms' (hot flushes etc) were manageable and my bone density was OK then local HRT on its own would be fine. But that's not the case. I DO have osteoporosis and it was diagnosed at a relatively young age. So that's the more serious long term risk that applies to me (but not to everyone). I'm also aware I have osteoporosis. There are many women who don't know they have it.
My friend has been diagnosed with osteopenia. She doesn't take HRT although she knows I do. That's her decision entirely. I don't interfere. Her relative risks may differ. She may well have already decided that the risks of HRT aren't worth it.
Sometimes I question whether taking HRT is a crazy idea but my thoughts always come back to my bone health. I know there are risks but I also know there are benefits. I just try to keep an eye on things and report any symptoms or concerns ASAP. I'm not complacent.
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HRT gives continued protection so why come off?
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Butterfly22, I don't know if I have it or not. I don't take hrt and so I wanted to check my bone health. I should get the results of that Monday. As far as I know, there are things we can do to prevent and reverse it. I will look for the form they gave me at the bone scan and post in a bit.... X
Anais, I agree with you. No need at all to fall out whether we take hrt or not, it's each individuals choice, based on what they individually believe to be right for them.
Sorry you have osteoporosis, have you been told you can reverse this? Again, on my form they listed the medication choices for osteoporosis... looking for the form.. X
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Hello everyone,
I've read this whole thread and there's a lot of misinformation and inaccuracies. I won't go on about them. Just want to say that 95% of all cancer types are multifactorial, which means that a lot of factors are at play. Only 5% are inherited and purely genetic. The risk factors for cancer are different depending on the specific type of cancer.
Regarding breast cancer, some risks have already been quoted above, but they're not the only ones. There are risk factors you cannot change: genetic mutations, getting older, early menarche (first period) and late menopause, dense breasts, atypical breast hyperplasia and lobular carcinoma in situ (benign), family history, previous radiation therapy before age 30, DES (diethylstillbestrol), a drug used between 1940 to 1971 to prevent miscarriages, both users and offspring conceived during use are at risk.
The risk factors you can change are: not being physically active, being overweight or obese after menopause, reproductive history (having the first pregnancy after age 30, not breastfeeding and never having a full-term pregnancy), alcohol and taking hormones.
Some forms of hormone replacement therapy (those that include both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk.
Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk."
Source: CDC/US
I won't quote the previous posts but will add some info and my own opinion on the matter:
Birth control pills are taken by young women. One of the main key factors for cancer development is time. It takes a long time for a cell and its progeny to acquire the sort and number of mutations necessary to cause an irreversible state of deregulated multiplication. So time is an important factor for older menopausal women who are on HRT or not. The relative risk for women on HRT is slightly increased and that's what this meta-analysis study is about. The analysis has also produced other interesting results ('relative risks were attenuated by starting MHT after age 60 years or by adiposity, with little risk from oestrogen-only MHT in women who were obese).
There are no randomised controlled studies on HRT spanning 26 years, so that's why this meta-analysis is so important. Time of exposure is of the utmost importance for accessing cancer relative risks.
I sincerely doubt that the pharmaceutical companies will dispute the study. On the contrary, they will probably update the leaflets in no time. HRT is not their priority, health and money wise.
The fact that this study has come out during the HRT shortages is purely coincidental, studies take a long time to be drawn up, accepted and published. There's another possibility that could also be inferred from the timing of this report. Maybe some pharmaceutical companies knew about this study prior to its publication and decided to stop manufacturing hormones until further developments? It's highly unlikely, but also possible.
Newspaper headlines and reports can't usually be taken as scientific or accurate. It's often useful to read scientific or specialised reports instead of general media reports. The authors of this study are prominent scientists in the fields of Epidemiology and Statistics and they are doing an excellent job helping women getting informed about the relative risks of taking hormones. Newspapers editors are another story.
Medical doctors (private or NHS, or both) have their own opinion on the matter, but that's what it is, their opinion. I wouldn't take their word as gospel, when many are on the hormone business.
I could go on an on, but this is not important. The important thing is: Know thyself, knowledge is power. Don't let panic, anxiety, fear, anger or misinformation take control.
Overall, this is good news for all of us, on hormone therapy or not, the more we know about this subject, the more we know about ourselves.
BeaR.
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What a wonderful, Informative and balanced post.
Thank you BeaR :)
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Great post Bear! Good info! X
Re the bone scan, on the form they gave me, it says deficiency in calcium and vit d is a cause, also hormonal factors can be a cause and also bone mass developing insufficiently.
Treatment:
A balanced diet, regular calcium intake including in diet, vit d intake through sunlight, stop smoking, reduce alcohol, exercise to increase bone strength.
It says Bisphosphonate is main treatment and another is parathyroid hormone treatment with daily injections. It doesn't mention hrt as a treatment or prevention on this form I was given by the nurse at the bone scan, although some sites online do mention it as a treatment, along with the others. Hope this helps! X
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Thank you everyone for the links and additional information. It is a minefield and I know statistics can be interpreted in different ways. The fact the study is not a RCT means that it is not gold standard research as others have said.
What concerns me most is the effect this study may have on doctors and medical staff attitudes at a time when HRT is in short supply.
We all weigh up risk and benefits and we should of course be able to make informed choices, but the studies are not robust as they do not take into account individal differences.
I do not want a doctor or nurse pratitioner telling me that the risks are too great and therefore do not wish to prescribe HRT, which for me makes the difference between being able to function and not.
We all have our own way of getting through this, it is an individual choice, and everyone should be supported in their journey.
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Agree entirely with Shropshirelass,
Quote from BeaR:
Medical doctors (private or NHS, or both) have their own opinion on the matter, but that's what it is, their opinion
BeaR is correct but their opinion, ( whatever it may be) affects directly my/ your/ our medical treatment as they are the gatekeepers...
It's all very well to know thyself look after thy self - I entirely agree with all of that but in the end of the day the doctors decide for us what they deem is best.
We are not in control of our destiny and choices if these decisions are made for us.
🐾C
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Statistics can prove anything from anything about anything ........ I worked with a few statisticians years ago :-\. What I want is hard evidence, not possibilities or maybes.
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Statistics can prove anything from anything about anything ........ I worked with a few statisticians years ago :-\. What I want is hard evidence, not possibilities or maybes.
You might have to wait a long time CLKD. Science is not an exact but an evolving process. What is claimed to be cast iron fact, one year, can be disproved the next.
As for pharmaceuticals, a lot of money is made out of them, so I much prefer research that is done by academics than by big pharmacy. Excluding that which is covertly funded by pharma of course.
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BearR, thank you for your sensible and comprehensive post.
I read some of the articles then checked my HRT-I'm on Indivinia (for 18 months now) and read the pack info, then had fear grip my stomach and was fighting back tears. Then I took some deep breaths and read the balanced sense. I thought about the gynae “advice†I got age 16, which was a load of tosh, as I discovered. I didn't start my periods till I was 17.At 16 I was only 4st 10, and my pushy mother took me to see this (horrible) gynaecologist. The examination was creepy and he said/told my mother I should never go on the pill and my chances of ever getting pregnant anyway were very slim.
I left home, saw a fabulous Dr, and the rest is history! I was on the pill from 20, had 2 wonderful children and turned 60 this year. I'm not obese, a little overweight so try to be careful, hardly drink, don't smoke and HRT has improved my life significantly. I will see my Dr at my annual review and no longer feel the fear.
Apologies for rabbiting on but I feel better for thinking it through.
Padine xx
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Hello ladies.
This is such an interesting topic plus a lively discussion.
I also think knowledge is power no matter how unpalatable the information may or may not be.
The Cell Biologists who wrote an article in The Guardian last week bemoaned the lack of research into the causes and effects of the menopause. It was only when she began to suffer that she realised so little was understood about the process.
The menopause is traumatic for many women so we need to keep the subject newsworthy and we owe it to ourselves to be open minded about treatments.
We are all in this together girls and surely we all want the same thing: an effective, safe and appropriate treatment that gives us a decent quality of life with minimal risks to our future health. A tall order! Let's hope the cell biologist and her colleagues can make it happen.
Wishing everyone well and sending hugs to you all.
K.
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Ah thank you, I wasn't given anything in fact I was going every six years when I was living in Newcastle moved to the county and had to keep saying to the doctor I'm suppose to get bone scan. She sent me in the end and they said you must come every three years. Xx
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Ah thank you, I wasn't given anything in fact I was going every six years when I was living in Newcastle moved to the county and had to keep saying to the doctor I'm suppose to get bone scan. She sent me in the end and they said you must come every three years. Xx
Thanks so much for passing the info on 😘
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That's ok Butterfly! :)
What did they tell you to do when you were diagnosed with Osteopenia? Did they give you Calcium supplements and if they did, did they say to take 1200mg a day, twice 600mg? X
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BeaR- great post. Thank you 💐
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That's ok Butterfly! :)
What did they tell you to do when you were diagnosed with Osteopenia? Did they give you Calcium supplements and if they did, did they say to take 1200mg a day, twice 600mg? X
They just said you have osteopenia, take calcium which o was getting off the doctor but it suddenly stopped. So just buy my own I'll have to check the strength. I don't drink or smoke gave that up 11 yrs ago xx
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Hello ladies.
I am thin boned and had Ulcerative Colitis which can be a risk factor for Osteoporosis etc due to poor food absorption. Nevertheless scans have never been mentioned. Can I ask, has anyone been given dietary advice to protect their bones?
Thanks ladies and take care.
K.
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Thank you everyone for the links and additional information. It is a minefield and I know statistics can be interpreted in different ways. The fact the study is not a RCT means that it is not gold standard research as others have said.
What concerns me most is the effect this study may have on doctors and medical staff attitudes at a time when HRT is in short supply.
We all weigh up risk and benefits and we should of course be able to make informed choices, but the studies are not robust as they do not take into account individal differences.
I do not want a doctor or nurse pratitioner telling me that the risks are too great and therefore do not wish to prescribe HRT, which for me makes the difference between being able to function and not.
What concerns me most is the effect this study may have on doctors and medical staff attitudes at a time when HRT is in short supply.
We all have our own way of getting through this, it is an individual choice, and everyone should be supported in their journey.
Hi shrosphirelass,
'Statistics can be interpreted in different ways'.
True, but I reckon the authors are well aware of that and I couldn't find any biased interpretation in this particular study. Have you?
'The fact the study is not a RCT means that it is not gold standard research as others have said.'
True, but many data used in this study is from RCT studies. The fact that this is a meta-analysis doesn't diminish the importance of this study.
'I do not want a doctor or nurse pratitioner telling me that the risks are too great and therefore do not wish to prescribe HRT, which for me makes the difference between being able to function and not.
What concerns me most is the effect this study may have on doctors and medical staff attitudes at a time when HRT is in short supply.'
It's likely that NICE and BMS will publish a comprehensive set of guidelines incorporating the new findings, so patients can 'educate' doctors and medical staff, IF they're not aware of it. It's time to be proactive.
'We all have our own way of getting through this, it is an individual choice, and everyone should be supported in their journey.'
Agree. In order to make an individual choice, we need all data analysis published and scrutinised.
BeaR.
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Sorry, but, where did you find any new findings!?
This were about old findings fro the very study that was later discredited as a flawed one!
So many doctors had already explained!
Links are in this thread.
Please go beyond the headline, however alarming it was, and how irresponsible by media was to publish it.
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Sorry, but, where did you find any new findings!?
This were about old findings fro the very study that was later discredited as a flawed one!
So many doctors had already explained!
Links are in this thread.
Please go beyond the headline, however alarming it was, and how irresponsible by media was to publish it.
Many existing studies were used in this new study, which was funded by Cancer Research UK and the Research Council.
All seems Kosher to me.
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As has already been said by Prof Michael Baum – the study is extremely complex and entails very involved multivariate statistical analysis in relation to a condition for which there are many confounding factors as all the medical experts have recognised and several of us have pointed out on here.
This is what he said: “This paper is extremely difficult to understand even by an expert like me, and I would need many hours to ingest it allâ€
Medical doctors (private or NHS, or both) have their own opinion on the matter, but that's what it is, their opinion. I wouldn't take their word as gospel, when many are on the hormone business.
BeaR.
I'm not sure what you mean here bear? Because this is a statistical analysis of a collection of data it is all open to interpretation, including from the authors of the study. The medical doctors (private and NHS) who have provided the main critiques of this study are forming an informed judgement based on the evidence. Do you mean that you do not trust their opinion – because they are “on the hormone business� I really don't understand what you're saying. Of course they prescribe hormones – it is their job to prescribe appropriate licensed medication including HRT. There have been many informed responses to the study by leading gynaecologists and menopause specialists. I for one trust that they have read understood and digested this new study and have found its flaws and where appropriate recognised its strengths far better than I can with my limited understanding of it all.
Statistics can prove anything from anything about anything ........ I worked with a few statisticians years ago :-\. What I want is hard evidence, not possibilities or maybes.
It is important to distinguish between a mechanistic or biological explanation for how things work – on individuals - (our bodies, our cells, and the effects of drugs and medications on our cells and hormones etc), and the effect on populations – which examines the differential effect of those treatments - because each individual will respond in a slightly different way even though the underlying biological principles are the same. Because we are genetically different including minute differences in our cells and enzymes etc then in order to find out if something works or not we need to carry out population studies and to be meaningful there has to be statistical analysis. We can't just say eg 55 % experienced this effect of a particular medication but 45 % didn't therefore it must work. We need to know how many people it was tested on and so forth. How you group the populations (and data) to be tested and the statistical analysis chosen can vary enormously and can influence the outcome and differential interpretation and is therefore open to criticism. This is especially important in discussion of risk and causality.
As yet, as far as I know the proposed mechanism whereby oestrogen actually causes breast cancer is not established – although there are explanations regarding oestrogen-receptive cancers and oestrogen causing these to grow ( when they have arisen by other means). Re genetic factors and the BRAC gene – I don't know anything about this but not really the subject of this thread so won't get distracted. Also beyond my knowledge...
One other point that has been raised re doctors and practitioners telling us what we should and should not take. I like Prof Baum's point on this:
“In the modern era paternalism of the profession has been replaced by the principle of partnership whereby patients are helped to make informed decisions.â€
I'd like to fly that as a banner in every surgery and clinic up and down the land!
Well said and please all of you take control of your own health and do not let any doctor or nurse tell you that you cannot take HRT (unless there is a very good specific medical reason why you should not do so) if you want to do so, nor take you off it against your will and without adequate reason.
Sorry got carried away there!
Prof Baum's statement has been linked to before but here it is again (from Louise Newson's website) for those who don't have time to read the whole thread:
https://www.menopausedoctor.co.uk/news/leading-breast-cancer-specialist-professor-michael-baum-responds-to-irresponsible-reporting
Re NICE - I understand (from another site) that they plan to send an alert to GPs after this news has come out and let's hope the alert is a balanced response and advice.
Hurdity x
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Sorry, but, where did you find any new findings!?
This were about old findings fro the very study that was later discredited as a flawed one!
So many doctors had already explained!
Links are in this thread.
Please go beyond the headline, however alarming it was, and how irresponsible by media was to publish it.
'The clinical relevance of the main findings lies in the magnitude of the absolute risks during and after MHT use for women who start MHT at ages 40–59 years (figure 7; appendix pp 24–27), but the public health relevance depends additionally on the numbers of women previously and currently exposed. Although use of either type of MHT for less than 1 year was associated with little subsequent risk, for women of average weight in developed countries 5 years of use, starting at age 50 years, would cause an appreciable increase in the probability of developing breast cancer at ages 50–69 years. About half the excess would be during the first 5 years of current use of MHT, and half would be during the next 15 years of past use. The absolute increase would be about 2·0 per 100 women (one in every 50 users) for oestrogen-plus-daily-progestagen MHT, 1·4 per 10 women (one in 70 users) for oestrogenplus-intermittent-progestagen MHT, and 0·5 per 100 women (one in 200 users) for oestrogen-only MHT.
There is little difference in the absolute excess incidence by age 70 associated with starting 5 years of MHT use at
ages 45 years, 50 years, or 55 years. Thus, addition of a daily progestagen increases the excess risk of breast
cancer from one in 200 users to one in 50 users. The corresponding risks with 10 years of use starting at age 50 years would be about twice as great.'
The Million Women Study wasn't flawed. Are you confusing it with the Women's Health Initiative trial?
I don't take doctors words as gospel, as I have already said before.
I think I have gone far beyond the headlines and I'm very happy with this study. You seem to be very concerned, though. Why? Do you think newspaper headlines will define what doctors and nurses will do from now on?
BeaR.
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However: what's a Girl to do when the GP tells them that they won't be prescribing medication? Which they are quite within their right to do. These days there is so much risk to the of litigation.
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I brough this up with my Meno dr after my GP nagged me every three months about risks. She said it is my right to decide what I want to be on if I choose to be on HRT she has to give it to me.
So, I printed one from articles at that time, one about this very study bein discredited, and took it with me to GP.
It said very clearly that the risk is to women with large breasts, who are obese, and on booze.
Here is the best summary I've read so far:
1. Women who take HRT are less likely to DIE of breast cancer than those who've never taken it
2. Women who take HRT and do develop breast cancer have a significantly better 10 year survival (80%) than those who've never taken it (64%)
3. Women who take HRT have a lower all-cause mortality than those who've never taken it - due mostly to a substantially reduced risk of death from heart attack
4. The risks of being denied HRT far outweigh any from taking it, as there is a “Mortality Toll†from HRT avoidance
When I was deciding to go on HRT, which we all know that is not perfect, only one thing was known for sure, that it protects against Osteoporosis. My Grandma spent her last 5 years in bed with broken bones that could not be put back together from it, so genetically I am prone, hence my decision. I am 19 years on it, and intend to continue!
Best!
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I don't think that a GP has to prescribe anything even if a Consultant suggests it, if the GP doesn't think it is in the patient's best interests. Which is why it can be such a battle.
Many++ years ago my GP said to me "What would you say if I told you that because of my Religion I won't prescribe the Pill?" "You're personal feelings shouldn't come into it". I got The Pill :D
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Hi Orrla, I'm surprised by that 4 point summary. Can you say where that came from? Ie who was it written by and where can I find it? Thanks.
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Hi Jari,
I took it from an other post on this very thread, on page 4 or 5, I think..
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CKLD, yes you can!
They have their hierarchy and must obey. If not, complain.
Fight for your rights!
or, go to meno clinic!
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As has already been said by Prof Michael Baum – the study is extremely complex and entails very involved multivariate statistical analysis in relation to a condition for which there are many confounding factors as all the medical experts have recognised and several of us have pointed out on here.
This is what he said: “This paper is extremely difficult to understand even by an expert like me, and I would need many hours to ingest it allâ€
Medical doctors (private or NHS, or both) have their own opinion on the matter, but that's what it is, their opinion. I wouldn't take their word as gospel, when many are on the hormone business.
BeaR.
I'm not sure what you mean here bear? Because this is a statistical analysis of a collection of data it is all open to interpretation, including from the authors of the study. The medical doctors (private and NHS) who have provided the main critiques of this study are forming an informed judgement based on the evidence. Do you mean that you do not trust their opinion – because they are “on the hormone business� I really don't understand what you're saying. Of course they prescribe hormones – it is their job to prescribe appropriate licensed medication including HRT. There have been many informed responses to the study by leading gynaecologists and menopause specialists. I for one trust that they have read understood and digested this new study and have found its flaws and where appropriate recognised its strengths far better than I can with my limited understanding of it all.
Hurdity x
Sorry, but Prof. Baum has said himself that he, an expert, finds it extremely difficult to understand this paper, so what makes you think that the 'many informed responses to the study by leading gynaecologists and menopause specialists' are responses based on a deep understanding of this study?
At this time it's dangerous to jump to any conclusions, both pro and against the study. I think it's great to have studies like this to be scrutinised by everyone interested in the subject and affected by it. Time and a lot more research will tell.
Regarding the hormone business, I was referring to doctors that are 'menopause experts' and make money out of menopause treatments in their private practice. Nothing wrong with that! I just don't take their word as gospel, they are entitled to their 'expert' opinions, but as a scientist myself I regard them as peers, not authorities. They can sell and prescribe HRT as much as they see fit, but diminishing the importance of this study like this quote from Prof. Studd, posted on this thread...
'Transdermal oestrogens , gels patches or implants with minimal progesterone (not synthetic progestogen ) is very safe and beneficial
Be careful of these controversial studies announced at a press conference on Wednesday
, embargoed until publication on the Friday. It then becomes front page news before the
scientific community have been able to study the complex data The same Oxford group
played the same trick 10 years ago with their flawed Million Women Study and the
discredited and harmful WHI study'
... sounds very unprofessional to me. To say that any drug is 'very safe and beneficial' is also reckless, no drug can be called very safe, particularly drugs that have not been the subject to extensive and appropriate long term studies. Bioidenticals are better than non-bioidenticals, but they are drugs, have side effects and have not been prescribed for an extended period of time yet. The argument that non-oral HRT is safer than oral is correct, but that doesn't make it 'very safe'.
Implying that brilliant Epidemiologists are 'playing tricks' is just beyond my comprehension. No comment.
BeaR.
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I HATE the word 'expert' with a vengeance . No one is 'expert' at anything. So-called 'experts' have caused enormous problems in the health service :'( :-\
It amazes me that people drink and/or smoke without giving much thought to health issues but HRT raises it's head and everyone jumps on the 'it's dangerous'. If it is so dangerous why aren't women advised to have breasts removed prior to HRT treatments?
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I HATE the word 'expert' with a vengeance . No one is 'expert' at anything. So-called 'experts' have caused enormous problems in the health service :'( :-\
It amazes me that people drink and/or smoke without giving much thought to health issues but HRT raises it's head and everyone jumps on the 'it's dangerous'. If it is so dangerous why aren't women advised to have breasts removed prior to HRT treatments?
Drink and tobacco are recreational. HRT is prescribed by the NHS.
I think there is a clue there.
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I brough this up with my Meno dr after my GP nagged me every three months about risks. She said it is my right to decide what I want to be on if I choose to be on HRT she has to give it to me.
So, I printed one from articles at that time, one about this very study bein discredited, and took it with me to GP.
It said very clearly that the risk is to women with large breasts, who are obese, and on booze.
Here is the best summary I've read so far:
1. Women who take HRT are less likely to DIE of breast cancer than those who've never taken it
2. Women who take HRT and do develop breast cancer have a significantly better 10 year survival (80%) than those who've never taken it (64%)
3. Women who take HRT have a lower all-cause mortality than those who've never taken it - due mostly to a substantially reduced risk of death from heart attack
4. The risks of being denied HRT far outweigh any from taking it, as there is a “Mortality Toll†from HRT avoidance
When I was deciding to go on HRT, which we all know that is not perfect, only one thing was known for sure, that it protects against Osteoporosis. My Grandma spent her last 5 years in bed with broken bones that could not be put back together from it, so genetically I am prone, hence my decision. I am 19 years on it, and intend to continue!
Best!
Hi orrla,
I also would like to know which studies are behind those conclusions. Any chance of a link?
I understand your fears, and osteoporosis is a big one. No one is saying that HRT cannot be taken by women who have an underlying condition that can be treated by hormones, particularly surgical menopause. Osteoporosis is a valid motive for hormonal therapy when there's family history of the disease, which by the way, is my own case. My Mum had osteoporosis, I'm not on HRT (long story) but I have annual DEXA scans to keep an eye on it, and if my readings get worse I will do whatever it takes to improve them, diet, exercise and as a last resource, HRT.
BeaR.
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The clue is in critical thinking, CKLD!
What works for me might not work for you, and opposite.
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I'm with you on this BeaR. Absolutely have no trust in private « meno specialists »
Of course they encourage women to take hrt, along with the follow up appointments and the odd minor surgery... they have their mortgages to pay. I don't trust a word they say...
I do trust my NHS GP, who is utterly against it, in my case. Plus for women generally, she says to take for the least amount of time.
Orrla, I can't find where your 4 point summary is written. If you see it again, can you post the link as I'd be interested to read it. Thanks!
X
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This is becoming like with abortion... or Brexit!
:-*
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Same as with abortion...
What??
I'm totally lost now. :o
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The Labours of Eve.
There is much moralising on 'interfering with nature'
Women were born to suffer.
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No matter how many times one will repeat over and over that chances of getting breast cancer are minimal, there always be that noise from ppl who read one headline and now are screaming that they do not trust experts, research, specialists, etc...
.... but trust blindly all sensational headlines!
ps: up until end of 19th century most women were dead before menopause, exhausted from numerous childbirth and work they were made to do, most were gone before their 50s.
Fast forward, our situation is of luxurious one in comparison to other parts, at least in UK or US.
Medical industry keeps developing new ways of extending our lives, including HRT, but nothing is perfect. Trial and error will get women there, eventually. So far most live beyond their 90 .... Dwell on this!
Good evening!
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Hi Orrla, I agree with you that people should not believe sensational headlines.
I still can't find your 4 point summary... it's stating the opposite of other reports, so I'd be interested in reading it, please post the link if you can find it..
Best to trust your instincts and read the facts and research reports, making sure to bear in mind who has written the reports and to ask ourselves if they might have some kind of an agenda.
Scientific reports are probably the best to trust.
Take care. X
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Or women were put into mental institutions due to becoming unstable with The Change. My granny had what we would call post natal depression but was locked away and had agerophobia for ever. :'(. Both grannies lived into their early 80s as did their sisters except 1, who died in her 50s. Both had access to fresh fruit and veg in season; sorry, I digress ::)
People drink/smoke without thinking about it, put an HRT prescription in front of them and they query every squiggle ::).
Quality of Life girls!
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Hi, this has inevitably created a lively debate but I think one thing we can all trust and agree about is the info on the Cancer Research UK site re breast cancer:
https://www.cancerresearchuk.org/about-cancer/breast-cancer/risks-causes/risk-factors (https://www.cancerresearchuk.org/about-cancer/breast-cancer/risks-causes/risk-factors)
This provides perspective and shows the multitude of factors at play for breast cancer cause, plus how we can proactively minimise our risks.
I think we can all agree that hrt is a personal choice that, like bcp, we would all rather never have to take in an ideal world. Much like any medication really which can all cause side effects.
What we do all deserve is quality individualised meno / hrt guidance so we can make an informed choice, balancing personal risks and benefits. Women should only ever be prescribed the safest forms of hrt. It's the nationwide inconsistency of this care that needs sorting out. Again, in an ideal world nobody should ever need to pay privately for it.
Im hoping that if our discussion is anything to go by the same is happening further up the tree that can bring more positive change for womens' healthcare (fingers crossed) x
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Whilst obviously no one wants breast cancer at all , I believe the study highlights risks of getting the disease, not dying from it . As has been stated , the data is complex but I feel the relative risks have been slightly better reported/explained in the media this time . But “ double the risk “ is not helpful ..!
I too feel sooo much better on HRT and whilst the paper is unsettling, I feel it gives useful information .
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Totally agree Bobidy and Sarah. Thanks for that link Bobidy. Very important to keep active, bmi watch and keeping alcohol to limits if at all.
Keeping hrt to under 5 years is also an important one. I hadn't realised the risk continues for 10 years after use.
This topic certainly does bring healthy debate.
Take care all. X
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Thank you Bobidy. That's very useful and reassuring information. :)
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It's been 17 years since the WHI study claimed that HRT causes breast cancer. Why did they not find another solution (besides AD's, Clonedine and Black cohosh)? Why do some women benefit from HRT while others don't? What about testosterone, SHBG, aromatase etc?
There are so many clues that hormones are involved in so many illnesses, mentally and physically, and still there is so little attention or research and so few options regarding treatment. I don't understand.
It's been on the news in Holland too and I'm afraid it will put us even further back into the Stone Age regarding menopause as no GP will prescribe HRT.
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I think you will always find different takes on HRT by experts. Just like experts say one day something is good for you & the next it's a known killer. Research is up & down
I found this research from Finland saying Reduced risk of breast cancer in post menopausal women on HT. There is different research & opinions all the time on HRT. We have to way up all that research & decide what is best for us
You have to copy & paste the link
https://www.ncbi.nlm.nih.gov/pubmed/27465718/
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You can just click on the link. You don't have to copy & paste it
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I'm with you on this BeaR. Absolutely have no trust in private « meno specialists »
Of course they encourage women to take hrt, along with the follow up appointments and the odd minor surgery... they have their mortgages to pay. I don't trust a word they say...
I do trust my NHS GP, who is utterly against it, in my case. Plus for women generally, she says to take for the least amount of time.
Orrla, I can't find where your 4 point summary is written. If you see it again, can you post the link as I'd be interested to read it. Thanks!
X
Re: Link to Guardian article this morning re increased breast cancer risk on HRT
« Reply #65 on: August 30, 2019, 02:31:15 PM »
ReplyQuoteModifyModifyRemoveRemove
Hi Ladies
I emailed Dr Karen Morton (consultant gynecologist) this morning about the HRT study and told her I was very worried about it, here is the reply she sent me.
Dear Jeana, I am sure you are not the only woman who listened to the Radio 4 broadcast with anxiety. I sometimes wonder what the press would do without these sort of studies to raise alarm about. I inset here the response that a colleague of mine, Dr Peter Greenhouse has written to the Editor of the programme wishing that the whole picture was better portrayed. 'To the Editor I hope you will have someone authoritative speaking in response to Prof Val Beral's Lancet study. Nobody should alter their HRT regime or consider not starting HRT because of this research because: 1. Women who take HRT are less likely to DIE of breast cancer than those who've never taken it 2. Women who take HRT and do develop breast cancer have a significantly better 10 year survival (80%) than those who've never taken it (64%) 3. Women who take HRT have a lower all-cause mortality than those who've never taken it - due mostly to a substantially reduced risk of death from heart attack 4. The risks of being denied HRT far outweigh any from taking it, as there is a “Mortality Toll†from HRT avoidance These four simple messages should be offered to the public with equal emphasis to the information from the Oxford group Lancet study.' So Jeana, I hope that reassures you. I do not think you should change anything, but of course, like all women, be vigilant about self examination and having your regular mammograms. Very best wishes, Karen
Jeana
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I'm with you on this BeaR. Absolutely have no trust in private « meno specialists »
Of course they encourage women to take hrt, along with the follow up appointments and the odd minor surgery... they have their mortgages to pay. I don't trust a word they say...
I do trust my NHS GP, who is utterly against it, in my case. Plus for women generally, she says to take for the least amount of time.
Orrla, I can't find where your 4 point summary is written. If you see it again, can you post the link as I'd be interested to read it. Thanks!
X
Hi Jari
I couldn't work out how to send you the post so I just copied the quote, hope it got to you ok?
I'm as confused and concerned about continuing to take HRT as I was after hearing about the study, just can't decide what to do?
Jeana
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Bear you clearly stated your view about not necessarily accepting the “opinion†of both private and NHS doctors in this matter (not taking "their word as gospel"), and Jari you are contrasting private menopause specialists (with whom you disagree because you feel they are only concerned with making money and therefore biased) with NHS GPs whom you do trust. As we have seen many NHS GPs simply are not “expert†enough (and yes I will use the word) – ie have insufficient specialist knowledge and understanding of these issues but you trust your own GP (who may well have the knowledge I hasten to add!).
However there are plenty of NHS menopause specialists and gynaecologists as well as scientists – which I mentioned before have produced informed responses to this study and whose “opinion†ie judgement of the papers I do trust (and even though I am also a scientist by training, I do regard as authorities while still having a critical eye as we all can whatever our background) since it is their job to understand it and advise.
There were many such responses – which have been linked to – including Prof Michael Baum – who is “Professor Emeritus of Surgery and visiting Professor of Medical Humanities in University College London (UCL), is a British surgical oncologist who specialises in breast cancer treatment. Not a private medical menopause doctor. He is also known for his contributions to the evaluation and support of patient quality of life. He has been Professor of Surgery in King's College London, the Royal Marsden Hospital and UCL.†Look no further than Dr Heather Currie who does not practice privately and who is the founder and manager of this site and whose balanced response is here:
https://www.menopausematters.co.uk/newsitem.php?recordID=204/Type-and-timing-of-menopausal-hormone-therapy-and-breast-cancer-risk which Emma linked to earlier (but this thread is long so you might miss it hence my linking to it again).
I think these two responses (Prof Baum and Dr Currie) speak for themselves.
There are also some more detailed responses some of which have not been widely published here including one from a statistician: https://www.sciencemediacentre.org/expert-reaction-to-study-looking-at-hrt-use-and-risk-of-breast-cancer/
Orrla I also looked for that summary and I have a feeling it appeared early on on Friday (or was it Thursday) but has been later edited.
For information the mortality data quoted in that summary I think comes from the Finnish study (which I think was also referred to in the Lancet paper?) which was reported a few years ago: https://thebms.org.uk/2016/07/breast-cancer-mortality-use-hrt/ This was also an observational study.
I like Prof Baum's opening statement: “Two principles in the practice of medicine – improve length of life (LOL) and quality of life (QOL). “ For many of us QOL for the 30-40 years we (hope to ) live beyond menopause, is paramount.
Have a good day girls :)
Hurdity x
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Hi Jeana1, thanks so much for finding that. I did look, but couldn’t find it.
I just don’t know. Firstly, I’m always pessimistic about « meno specialists » I’m afraid. Peter Greenhouse is one, so of course he doesn’t want this news out, because it deeply affects his pay pack.
But, I am curious that he openly says that women who take hrt are less likely to die of BC than women who don’t take it. ?!
I’m wondering,( if that’s true ), if that’s because women on hrt should be monitored frequently and therefore their BC is found sooner, so are treated quickly and hopefully don’t die from it and maybe women who are not taking it are not getting checked so much, or maybe skipping their mammograms.. I’m not sure. I guess that’s a possibility, but I’d like to see where he gets that figure from. Is it one he’s made up to suit his lifestyle, or is it out there as fact?! If it is, then it’s very interesting.
Thanks for sharing xx
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I'm with you Hurdity, thanks for the links. x
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Been away for a bit and haven't read all the posts in this thread, but as someone who had breast cancer 3 years ago (but not hormone receptive) I'm choosing not even to read this article. The sudden menopause brought about by chemo has made the last 3 years hell and I'm only now coming out of it, thanks at least in part to HRT. In my humble opinion quality of life is way more important than statistics about possible risk - I'd reached the point where I felt my life really wasn't worth living - give me HRT, whatever the risk, over that xxx
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Or women were put into mental institutions due to becoming unstable with The Change. My granny had what we would call post natal depression but was locked away and had agerophobia for ever. :'(. Both grannies lived into their early 80s as did their sisters except 1, who died in her 50s. Both had access to fresh fruit and veg in season; sorry, I digress ::)
People drink/smoke without thinking about it, put an HRT prescription in front of them and they query every squiggle ::).
Quality of Life girls!
Very true, i always say years ago I would of been locked up due to bad PMT. probably locked up and forgotten about. Your poor grannie though.
I also agree if you do smoke and drink this is greater risk, maybe give them up. Xx
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One of my best friends has terminal breast cancer. She has never taken hrt. She doesn't drink or smoke either (and never has done), she is overweight though. My point is you look at the studies and you weigh up the risks. The study doesn't put me off taking hrt; as several posters have said it's about quality of life, and on balance risks are so low I feel I'm far better off on it than off it x
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Thanks for the links Hurdity. Here's another one from the same year as the Finnish study, 2016.
https://thebms.org.uk/2016/08/breast-cancer-now-study-finds-effect-combined-hrt-breast-cancer-risk-likely-underestimated/
X
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I think that's what it comes down to perinowpost, personal choice, can you get by without it maybe taking natural route or can you really not function without it?
We are all different, starting at different times, different symptoms, different challenges in life so only we can say what's right for us.
Personally if it helps me I'll take it, I am a little different as started early but if I feel good in my 50's with it I'll take it.
Xx
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I do agree that we're all in different situations, with different levels of symptoms and we have to each decide, after having made the obvious lifestyle changes, what is best for us.
Quality of life does change drastically by losing weight if needed, giving up smoking, cutting down alcohol, eating a quality balanced diet and having regular good exercise. If we do all this and we still have terrible symptoms then of course hrt has to be considered... it is most definitely quality of life all round. X
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Thanks Hurdity (as always) for the fab info, and racjen for sharing your personal experience.
I also think that in the same way as I have started to blame each new twinge and ache etc on this damned peri meno, sometimes I do rationally know it can't all be down to that. My body will naturally just get these things.
I think hrt / breast cancer is the same. If a woman takes hrt and then gets breast cancer then the first thought is "the hrt must be to blame", but again rationally it could have been going to happen anyway for a number of unrelated reason. All the research in the world can't establish it's the hrt surely?
I'm definately going to continue on hrt (in the process of tweeking at the mo) and hope to take for as long as possible. I'm also going to continue under the care of Dr Newson until I'm totally confident that my current (uninformed) gps are capable of providing me with the same level of care. She is doing some amazing work to benefit us all for years to come. X
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Hi ladies
I have read through all of the posts and still none the wiser about what decision I should make, I'm not great with reading all the research as it actually confuses me more, I think I will discuss it with my gynecologist on my next appointment mid September. Maybe I am being naive but it was mentioned here that some private consultants may be speaking out against or maybe not against the research but are more "pro" the benefits of HRT because it would affect their pay packet if women stopped taking it, i would have thought that HRT is only a part of their daily appointments and have many other duties, i would like to think whether they are private or NHS they would still be professional and have the best interest of their patients over profit, maybe i'm to trusting.
I started HRT to help with crippling anxiety, health anxiety and depression, so bad I could not leave the house, I was put on various "head med's" which for me did not work and made this worse due to side effects ( I am not knocking antidepressants as i know they have been a life saver for many people) I was also prescribed Valium which I took every day for 18 months and have now tapered off, this has left me with benzodiazepine withdrawal syndrome which is awful but getting better. For me personally the HRT has given me my life back, I am still not fully there yet but have made a vast amount of progress since starting HRT and I continue to improve.
Personally I hope my Consultant (who is both private and NHS) reassures me, I don't want to come off it because I don't want to go back to the dark place I was in before I started it.
Jeana
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Thanks for the links Hurdity. Here's another one from the same year as the Finnish study, 2016.
https://thebms.org.uk/2016/08/breast-cancer-now-study-finds-effect-combined-hrt-breast-cancer-risk-likely-underestimated/
X
Thanks for that Jari - I only posted the link to the Finnish study because several were asking where orrla's summary came from (paisley I see you linked to it too and you must have posted your link as I was writing my lengthy post - sorry I didn't acknolwecdge you there!). The individual studies do tend to conflict with each other - because there are so many variables and as always we really do need specific information about the effect of bio-identical transdermal HRT on breast cancer incidence (and biology) gained from randomised controlled trials.
The BMS/RCOG responded to the study you linked to here:
https://thebms.org.uk/2016/08/bmsrcog-response-breast-cancer-now-generations-study-hrt-use-breast-cancer-risk/.
I'm absolutely with you always re lifestyle changes - diet, weight, exercise, alcohol - keep within normal BMI range and upper or lower end (of the normal range) is OK depending on your frame size but also how much muscle you have too. HRT alone is not the only way to potentially help improve our health and well-being!
Hurdity x
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Jeana1 - yes I would expect that first and foremost private consultants would be informed by the science otherwise they would be up for criticism. Most of the private gynaes are either published research scientists or extensively interpret and refer to it.
Please try not to worry - most of the (medical) responses refer to quality of life and some specifically to the debilitating effects and dangers of menopausal depression.
I am so pleased to hear how well you are doing on HRT and surely this is what matters now? You have decide to accept the potential small increase in risk of breast cancer in favour of the benefits you are experiencing. I don't think this recent news changes the balance diagram on this site here where the risks and benefits are simply portrayed by age with balance scales: https://www.menopausematters.co.uk/balance.php. The balance will be further tipped one way or the other depending on your own personal risk factors and potential benefits.
Good luck with your appointment and I do hope you will be reassured and stay well in the meantime :)
Hurdity x
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Hi Jeana,
I only speak from my own experience of paying to see a « specialist », which turned out to be a disaster and hence, why I don’t trust them.
Maybe I was just unlucky and I’m sure there are good ones out there, just like there are good GP’s out there etc.
I think we just have to go with our own gut feelings and assess what is right for us as individuals.
Good luck with it. X
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Hi Jeana1,
Don't let my personal views cloud yours. Your Consultant will probably explain everything you need to know to help you decide your next move. If you feel much better on HRT, that's great. If you are being monitored (scans and mammogram), you'll be fine. Risks are relative, even if this study has shown a slight increase in absolute risks, they have not considered all the factors than can affect those risks, for the simple reason that not all studies published so far and used in these analyses have those data.
Everything in life is risky, no one can control all the factors. Rest assured that this same sort of discussion happens everyday regarding other types of drugs for all sorts of ailments. Even paracetamol can cause serious liver damage if not taken correctly. That's why knowledge is so important. As mentioned above, even prominent doctors say we have to be their partners when it comes to discuss our health instead of expecting a paternal approach.
BeaR.
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Still reading 57 pages of the Supplementary Appendix of this study... I need a lie down :P
BeaR.
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Have a G&T. You won't care what it says then. :drunk:
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;D
Lanzalover x
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;D
I had to copy this as I couldn't read the print, it's too small ::)
Hi Ladies
I emailed Dr Karen Morton (consultant gynecologist) this morning about the HRT study and told her I was very worried about it, here is the reply she sent me.
Dear Jeana, I am sure you are not the only woman who listened to the Radio 4 broadcast with anxiety. I sometimes wonder what the press would do without these sort of studies to raise alarm about. I inset here the response that a colleague of mine, Dr Peter Greenhouse has written to the Editor of the programme wishing that the whole picture was better portrayed.
'To the Editor I hope you will have someone authoritative speaking in response to Prof Val Beral's Lancet study. Nobody should alter their HRT regime or consider not starting HRT because of this research because: 1. Women who take HRT are less likely to DIE of breast cancer than those who've never taken it
2. Women who take HRT and do develop breast cancer have a significantly better 10 year survival (80%) than those who've never taken it (64%)
3. Women who take HRT have a lower all-cause mortality than those who've never taken it - due mostly to a substantially reduced risk of death from heart attack
4. The risks of being denied HRT far outweigh any from taking it, as there is a “Mortality Toll†from HRT avoidance
These four simple messages should be offered to the public with equal emphasis to the information from the Oxford group Lancet study.'
So Jeana, I hope that reassures you. I do not think you should change anything, but of course, like all women, be vigilant about self examination and having your regular mammograms. Very best wishes, Karen
I thought in the early hours: are all breast cancers apparently triggered by HRT ?
How does 1 know they are affected by oestrogen :-\ which apparently mine was. I had used HRT for 4 months years++ prior to finding the lump. It was never seen on mammo.. [I never thought to ask how the Surgeon knew ......... . I did ask to see the slides but that request was denied].
Why aren't women told to have bilateral mastectomy at a certain age, i.e. mid-50s, in case they need HRT? Sorted?
Is it that women are monitored more when they take HRT so any breast disease is caught early?
Do women on HRT who have breast disease diagnose, die from cancer?
Clear as mud ::)
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I read the article in the Telegraph yesterday: not happy with the way that is written either >:(. Will need to read it again.
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Have a G&T. You won't care what it says then. :drunk:
Alcohol? Nooooooo :o I already have a lot of risk factors ;D :ange: :diablo:
BeaR.
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@Hurdity. You are amazing. :) :) :)
That is all.
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I'm amazing too :-\ .......... not every day but most ;)
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We all are amazing, menopause survivors. ;)
BeaR.
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:ola:
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Yay Jari :veil:
And to all ladies who have posted that this study does not take alcohol into account:
'To ensure women in one study were compared directly only with similar women in the same study, analyses were routinely stratified by study, centre or region within study, age (<40, single years of age from 40 to 69, 70-74, 75-79 and 80-89), body mass index (BMI <25, 25-29, 30+ kg/m2; ‘lean‘ = <25 and ‘obese' = 30+ kg/m2); adjusted for family history (first degree relative with breast cancer, yes or no), alcohol consumption (0, <10, 10+ g/week), and reproductive history (nulliparous, and, among parous women, by parity [1-2, 3+] and age at first birth [<20, 20-29, 30+ years]). They also allowed for age at menopause, but in a different way (see below), as this important information was not always available. For all stratification or adjustment factors the data provided by the principal investigators were used, with definitions as similar as possible across studies.'
BeaR.
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So the risk of GPs not prescribing having read theses articles, against the risk of women getting breast disease?
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So the risk of GPs not prescribing having read theses articles, against the risk of women getting breast disease?
Hi CLKD,
It's too soon for GP's to have an informed opinion based on this study, let's wait for scientists and medical doctors trained in Epidemiology and Statistics to scrutinise it, including NICE and BMS experts (I also don't like this word, but it seems to be everywhere now).
The risks of BC linked to HRT are well known and considered small, that hasn't prevented GP's from prescribing it. The absolute increases in risks verified in this study (still awaiting scrutiny) are also small when you consider individual cases, but it's significant for public health concerns.
I'm not sure I have answered your question, but that's my 2pworth. ;)
BeaR.
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The Study has obviously been 'out there' for a while because Louise had an article in Sat's telegraph :-\. Which I found difficult to understand and may be a pat response to scare mongering articles ? I need to re-read it.
Surely NICE should get to grips with any such startling information prior to the press getting their mucky hands on it?
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I thought research was presented to peers at conference etc for scrutiny before it was considered for policy.
The trouble with epidemiology and statistics is that it can find link, which this has done. We know that there is a link with breast cancer and HRT. But we do not know what that link is and hard science RCT are needed to find out what that link is and isolate the mechanisms, then something can be done.
We knew there was a link before, and this study shows that link exists (again) and that it may last longer than thought, but it still does not tell us what that link is. There have been a number of studies since the millennium and million women trials looking at different progestogens to see if that could be a cause, and detailed analysis of the numbers has shown that it could be an effect, but we need a lot more of this sort of research before we get any answers.
I don't know why this study got so much attention. They have only said there is a link and have not come up with anything that proves that HRT actually causes BC, and the study does not show that HRT increases the number of deaths from BC.
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Great post dahliagirl :)
Hurdity x
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I hope so - my brain keeps going round in circles ;D
Epidemiology is great for public health issues and it is great as an overview, but you do need more.
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I guess time will be the answer. As many more women take hrt now, they will start to see over the next decade, what will be the outcome. Hopefully by then they will have a clearer picture, but it's good they carry on with all this research in the meantime. 👍
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If I had 3 wishes...
I wish they would just move on now and focus their efforts, time and money into researching the effects of newer hrt preparations and testosterone. Something we would find useful. Maybe this is going on in the background?
I wish the headline was highlighting the urgent need for primary healthcare training in Menopause / hrt prescribing, moving away from old preparations with the greatest associated risk, and away from mis-prescribing anti depressants / pain killers. Surely this is the bigger issue? That way women's bc risk can be better assessed, although it seems most times it is unknown anyway.
I finally wish we could start some kind of petition to get this stuff through parliament. I know Diane Danzebrink is doing a lot of great work in this area.
I can but hope x
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Good idea Bobidy. I think you can start a petition?! Go to the gov petition site. Can't remember how to get there, but if you google it, you can then start a petition. I think it needs 10000 signatures (all online) to get debated in Parliament. X
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Bobidy, just looked it up...
https://www.gov.uk/petition-government X
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So true Bobidy, I'm not saying this is all that has come out but in the 20 years I've been taking hrt I've literally seen one new one added but a few discontinued. Some women really struggle finding a subtitle one, there needs to be more choice and certainly more help.
I think modern living, eating ect play havoc with us and it's worse then years ago plus ladies are living longer. X
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If I had 3 wishes...
I wish they would just move on now and focus their efforts, time and money into researching the effects of newer hrt preparations and testosterone. Something we would find useful. Maybe this is going on in the background?
I wish the headline was highlighting the urgent need for primary healthcare training in Menopause / hrt prescribing, moving away from old preparations with the greatest associated risk, and away from mis-prescribing anti depressants / pain killers. Surely this is the bigger issue? That way women's bc risk can be better assessed, although it seems most times it is unknown anyway.
I finally wish we could start some kind of petition to get this stuff through parliament. I know Diane Danzebrink is doing a lot of great work in this area.
I can but hope x
Just to refresh our memories, this is Diane's petition:
https://www.change.org/p/penny-mordaunt-mp-make-menopause-matter-in-healthcare-the-workplace-and-education-makemenopausematter
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Thanks for re-posting that petition Jenna :)
I guess time will be the answer. As many more women take hrt now, they will start to see over the next decade, what will be the outcome. Hopefully by then they will have a clearer picture, but it's good they carry on with all this research in the meantime. 👍
The main issue though is that just collection of data through what they term "prospective studies" does not provide a clearer picture and it is randomised controlled trials ( as well as biological investigation) that need to be carried out. Unfortunately I doubt there will ever be trials on the same scale as the WHI study which is why it continues to be quoted, but there are smaller trials which are carried out and reported - though they are never given the same promonence it seems.
Hurdity x
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Well said Ladies!
This is exactly what we need them for!
To cope with this modern world!
I don't want to burst up in tears each time some stupid narcissist has a go at me...
I want to be able to cope, as I did before all that Meno havoc!
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I was skeptical the moment I saw the newspaper headline. I am even more so now having read this debate and all the reactions from various meno experts. Thank you to everyone for posting them!
HRT has improved my quality of life immeasurably and I am sure is providing me with multiple health benefits. I won't be coming off it because of this rehashed research paper.
Thank you again for all your contributions. This site is an amazing resource for women!
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dahliagirl - eloquently put! My thoughts but can't get words into action these days :-\
I have Louise Newson's article to hand to read again.
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I thought research was presented to peers at conference etc for scrutiny before it was considered for policy.
The trouble with epidemiology and statistics is that it can find link, which this has done. We know that there is a link with breast cancer and HRT. But we do not know what that link is and hard science RCT are needed to find out what that link is and isolate the mechanisms, then something can be done.
We knew there was a link before, and this study shows that link exists (again) and that it may last longer than thought, but it still does not tell us what that link is. There have been a number of studies since the millennium and million women trials looking at different progestogens to see if that could be a cause, and detailed analysis of the numbers has shown that it could be an effect, but we need a lot more of this sort of research before we get any answers.
I don't know why this study got so much attention. They have only said there is a link and have not come up with anything that proves that HRT actually causes BC, and the study does not show that HRT increases the number of deaths from BC.
This study is the result of a joint effort of the Collaborative Group on Hormonal Factors in Breast Cancer, comprising 133 institutions around the world. I reckon they have discussed the study extensively before submitting it for publication, but of course there must be an equal number of scientists and other people trying to understand and possibly challenge their findings (it happened with the WHI trial). If the UK government is considering it for policy, I reckon it's because it's a robust study and the implications are serious for public health policy. https://www.gov.uk/drug-safety-update/hormone-replacement-therapy-hrt-further-information-on-the-known-increased-risk-of-breast-cancer-with-hrt-and-its-persistence-after-stopping
I don't see any problem in finding links, or associations. They are very useful for seeing the big picture as long as no causality is inferred. Epidemiology studies are about groups of people, not individual patients. No government could exist without it. Statistics is a tool for all scientific studies. No science would survive without it.
There are not enough data from long term use of HRT studies to be analysed and breast cancer takes a long time to develop, but in the meantime, scientists who have a lot of data at their disposal won't just wait for a ‘hard science RCT' until ‘something can be done'. The purposes of Randomised Controlled Trials are not to isolate mechanisms, these are done via molecular studies in vitro and in vivo, usually using model animals. To isolate hormonal mechanisms using humans as objects would be a bit complicated. RCTs are important to provide strong evidence of cause-effect, IF they are well designed and methodologically sound. They also can be flawed.
This is not the purpose of this study, all analyses on risk ratios are welcome, until molecular investigations can find ‘that link'.
What could be a cause and what could be an effect of what? Sorry I can't understand what you mean. Do you mean that ‘detailed analysis' of the use of different progestogens ‘has shown' that ‘it' (breast cancer?) could be an effect? If that's what you mean, yes, and as I said before, scientists work with available data and if ‘this sort of research (that we need a lot more of)' takes a long time to achieve any significant results, scientists can't just wait.
The study aim was not to prove causality. Actually, scientific studies rarely ‘prove' anything beyond doubt, they are usually about evidence that can corroborate hypotheses or about data collection, analysis and interpretation, like this one.
This objection 'the study does not show that HRT increases the number of deaths from BC' keeps being raised by many doctors and ‘experts'. From a purely personal point of view, I would like to know what are my chances of getting breast cancer if I'm on HRT, independently of what comes next. Breast cancer mortality rates depend on many other variables. From the public health point of view, it's very important to know that HRT use can increase the absolute risks of BC (which has been provided by this study) not just during the use of HRT (up to 5 years), but also 15 years after discontinuation (which is a new finding of this study), for the very important reason that the NHS and equivalents around the world are going to pay for those breast cancer treatments, not to mention the obvious implications for individuals.
This study is about numbers (patients, years of HRT use, age, risk ratios), it is not about proving causality, there's a big IF in the Interpretation section:
‘If these associations are largely causal, then for women of average weight in developed countries, 5 years of MHT, starting at age 50 years, would increase breast cancer incidence at ages 50–69 years by about one in every 50 users of oestrogen plus daily progestagen preparations; one in every 70 users of oestrogen plus intermittent progestagen preparations; and one in every 200 users of oestrogen-only preparations. The corresponding excesses from 10 years of MHT would be about twice as great.'
It would be useful if one can separate what has been demonstrated in a 67-page study from 1-page media reports.
It's nice to be able to discuss things deeply and not let emotions and preconceptions get in the way. Science can certainly be flawed but it's still the best tool we have to address these flaws.
Sorry for not multiquoting, it's terribly difficult when there's no such an option, at least I haven't found it.
BeaR.
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I don't know how HRT can be blamed for breast cancer that far down the line :-\. We are told that blood tests are reliably un-reliable. How can anyone prove that HRT can cause cancer by looking at paper work :-\ ?
No one has asked me back for discussion or further investigation even though my lump, in the 1990s, was supposedly oestrogen driven. I could have taken HRT after surgery and not been affected. I have routine mammograms even though the lump was found on palpation and never showed on film. There4, unless I get breast cancer in the future - I will never call it recurrence - I won't be asked for discussion as to how I've been over-all ...........
Confused. You bet I am >:(. Annoyed. Yep.
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This came out this morning:
More (post menopausal) women should take anti-breast-cancer drugs, US officials say
https://mol.im/a/7422841
I wonder why the progestogen use causes more breast cancer (in the main study been discussing) but here they are saying it’s oestrogen that needs reducing - which makes more logical sense for oestrogen driven breast cancer?
Perhaps it’s referring to non bio identical prog only, where natural prog would reduce the risks.
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The International Menopause Society comment (pdf)
https://www.imsociety.org/manage/images/pdf/2b650ccd4a2e0c63806d82ed2984ed69.pdf
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Thanks for posting this Emma - an illuminating statement and puts the study into perspective very clearly.
I do find it odd that the Government and specifically the MHRA saw fit to update their recommendations almost immediately on the basis of the published Lancet paper - without waiting for the latest analysis to be properly scrutinised and taking into account the very specific and valid points made in the IMS statement notably relating to the types of HRT now being commonly prescribed. It's like it was a knee-jerk reaction to all the Press publicity?
MHRA statement sent to health professionals last week:
https://assets.publishing.service.gov.uk/media/5d68d0e340f0b607c6dcb697/HRT-patient-sheet-3008.pdf
Hurdity x
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..which, combined with a severe shortages can make one quite suspicious of what's going on, I'd say...
I am hoping that there will be some explanation soon, of why this paper got such a coverage, etc.!
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Interesting comments from Liz Earle. I agree with her opinion on this video. I have used HRT for many years and followed the research carefully.
https://twitter.com/BBCWorldatOne/status/1167460712597397504
Katy x
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Can't read the report as having an anxiety attack even at responses by you guys so far - more nervous than ever- not about the increased cancer risks ( I am personallymore at risk of stress and insomnia related disease including heart attacks and depression) but palpitations and shortness of breathe at what is likely to be an even bigger battle to get HRT through GP's NHS or otherwise. :'(
Ironically on way to GP's now to discuss increase in dose..
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Please listen to this new podcast from the goddess Dr Newson. She chats with Liz Earle about this 'new' bc scare headline and puts it all into perspective:
https://www.menopausedoctor.co.uk/podcasts/s1e13-hrt-and-breast-cancer-dr-louise-newson-and-liz-earle-mbe (https://www.menopausedoctor.co.uk/podcasts/s1e13-hrt-and-breast-cancer-dr-louise-newson-and-liz-earle-mbe)
As you know I'm totally biased but all her podcasts are great and you can find them here:
https://www.menopausedoctor.co.uk/podcasts (https://www.menopausedoctor.co.uk/podcasts)
This one in particular discusses the original flawed research in more detail (about halfway through):
https://www.menopausedoctor.co.uk/podcasts/symptoms-and-effective-treatment-for-women-experiencing-the-menopause-and-peri-menopause (https://www.menopausedoctor.co.uk/podcasts/symptoms-and-effective-treatment-for-women-experiencing-the-menopause-and-peri-menopause)
You may need to download Podbean first.
I found this reassuring, I hope you do too xx
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The International Menopause Society comment (pdf)
https://www.imsociety.org/manage/images/pdf/2b650ccd4a2e0c63806d82ed2984ed69.pdf
Thank you for the link, Emma.
Firs of of all, the IMS comment begins with a question in bold letters ‘Is there new information that menopausal hormone therapy (MHT) substantially increases breast cancer risk as suggested by a paper published in the Lancet this month (1) and should women be worried?'
There are 4 hits for the word ‘substantially' in the study:
In general, the RR did not differ substantially
by the progestagenic constituent of the combinations,
including rarely used hormones, such as micronised
[natural] progesterone (RR 2.05, 1.38–3.56), although
the RR appeared to be somewhat lower for oestrogen
plus dydrogesterone (appendix p 45).
Most studies provided data on tumour characteristics.
RRs in current users during years 5–14 were substantially
greater for ER+ than ER– tumours and for lobular than
ductal tumours, but were similar for localised tumours
and tumours that had spread beyond the breast (figure 5).
The appendix (pp 46–47) gives further results by ER
status.
Risks did not differ substantially
between the main oestrogenic constituents,
or by whether
oestrogens were administered orally or transdermally.
Ovarian function ceases with menopause; thereafter,
oestrogen levels fall substantially and progesterone levels
fall to near zero.
So I reckon the IMS comment refers to their own perception/interpretation that the risks for BC are substantially increased by HRT (MHT) or more likely, that this important and misleading word has been borrowed from media reports instead.
I have other observations on the IMS comment, I don't have enough time now, but will do it later on, although my own perception of this thread is that I'm talking to myself. Anyway, I like talking to myself.
BeaR.
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Definitely not talking to yourself. I’m very interested to read your very informative posts! ;) x
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Ah, thank you, Jari. I was going to comment on your last one, but the thread has escalated and I forgot. I will do it later on today. :)
BeaR.
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Sorry if anyone is going to be offended by my rant but I feel extremely (!!!! a million exclamation marks...that's how extremely!) strongly on this. I am in two minds about posting this but my very own personal opinion on the subject for what it's worth and it's probably not helpful to anyone but me, so here goes....
should someone wish to stop or reduce my hrt based on the "risks" my answer is "without hrt I would be dead by my own hand so if it increases my chances of being dead through breast cancer, then it is a chance I am willing to take! I now have a life thanks to it after 20 years of no life at all, 10 years of which was menopause Armageddon.
I am buoyed by the words of people who "know" like Louise Newsom, Liz Earle, and the cancer doctor (can't remember his name)
but what scares me more than the "research" paper is how quickly NICE have reacted and how quickly we seem to have been thrown back to the time the last discredited study stopped millions of women getting hrt and consigned them to a life of hell....that no man would countenance if it happened to them! I also agree with orlaa that "combined with the shortages" something stinks...
More and more women have been asking for hrt over the last few years, call me cynical (I am flaming cynical!) but maybe "women having a life" is costing the NHS too much?? Maybe Diane's petition and the new focus on helping menopausal women in the workplace has frightened the powers that be...so the answer is to try and scare us sh**less. Makes my blood boil in case you hadn't guessed. Our very own menopausal "project fear" if you like!
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The International Menopause Society comment (pdf)
https://www.imsociety.org/manage/images/pdf/2b650ccd4a2e0c63806d82ed2984ed69.pdf
Thanks for posting Emma
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I have been reading through this the last couple of days and also follow Dr Newson and Liz Earle. What they say makes sense but why are the medicines authority issuing revised guidelines (linked a couple of posts above)? I just don't get how the authority can be so wrong unless it's to do with shortages or funding or something... I posted on this forum a few times when I tried Hrt earlier this year (Oestrogel/Utro) but the Utro made me zombie tired and depressed so came off it myself as my GP knew little. I tried to go it alone but last 3 months horrendous night sweats and feel like I haven't slept for ever. Finally decided to see a private London doctor who wasn't the expert she marketed herself as and prescribed out of stock patches. Recently I was thinking of going back to GP and the supply issue kicked off and then this scare....
I just don't know what to believe or think anymore not helped by tiredness and the conflicting views. How are we meant to make decisions when experts disagree??
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What happens to individual choice?
It should not be up to others to decide for a woman, we should be given available information ( conflicting or not) and ultimately be allowed to decide for ourselves, balance our own risks, benefits.
For the women that do not want to take HRT that is fine. For the women who do want to take HRT then that is fine too, no one needs to be hectored by others opinions on either side of the fence - each to their own!
🐾C
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I agree Callisto - when you read the forum posts there are always occasions when Doctors don't have a clue about hrt and then spout on about what they will and won't prescribe. A lot of them don't follow the current guidelines and give those who want it what they need. You are spot on, if you want hrt and are comfortable with any risk, it's your choice, if you are not comfortable and don't want it, it's also your choice but my huge worry about shortages and this study combined is that, it seems whatever we want...it's going to be a problem xx
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Continuing my own analysis of the IMS comment (in bold) on the study:
The authors have tried to minimise bias in their analyses, but it is important to recognise that observational studies include unquantifiable confounding effects, for which corrections cannot be made, and so as in all studies, there are limitations.
Correct. The authors have tried to minimize bias using the available current tools to achieve that.
Correct: all studies have limitations.
It is extremely important to note that this paper does not inform us of the impact of current recommended MHT prescribing practices on breast cancer risk.
It's quite difficult to quantify the impact of current MHT prescribing practices on BC risk, for the obvious fact that BC takes time to develop and the ‘current recommended MHT prescribing practices' are only going to show (or not) increased BC risks over time.
With an average use of 10 years of MHT in current users at diagnosis, and 7 years in past users, much of the exposure to MHT preceded the first publication of the Women's Health Initiative study, after which prescribing practices changed substantially. Consequently, virtually all of the included information pertains to MHT formulations and doses known to have adverse breast effects that are no longer recommended. Specifically, the use of the progestogens medroxyprogesterone acetate and norethisterone (norethindrone) is now discouraged because of their known adverse effects, but these account for nearly all of the data for combined estrogen-progestogen therapy included in the paper.
I had no idea norethisterone is no longer recommended and now discouraged. (!)
Additionally, the majority of cases were women who took oral estrogen, which results in high blood levels of the hormone estrone, whereas transdermal therapy does not (2). Estrone is not only the main estrogen produced by postmenopausal women, but levels are higher in overweight/obese women, such that estrone may be a key factor linking obesity with breast cancer.
I'd like to see references for these affirmations.
Estrone is the main oestrogen produced by postmenopausal women, but this is a normal shift in the metabolism of oestrogens, also seen during pregnancy, when estriol rises. Nature is wise, older women with lots of cell genetic mutations (including oocytes) should not have increaed risks of cell multiplication by mitogenic estradiol, thus estrone and not estradiol, which main function lies in reproduction, takes over.
Estrone is reversibly converted to estradiol through the action of 17β-hydroxysteroid dehydrogenase enzyme in peripheral tissues, so it's not easy to separate the potential roles of estrone and estradiol in BC. https://cancerres.aacrjournals.org/content/79/13_Supplement/590.short
‘A number of known breast cancer risk factors have been proposed to influence risk via effects on estrogens. Obesity, defined as BMI> 30 kg/m2, raises the risk of postmenopausal breast cancer, and this has been attributed to the higher circulating levels of estrogens synthesized in the adipose tissue of obese women. At the same time, an inverse association between obesity and SHBG blood levels has been reported, which in turn, contributes to higher concentrations of free estradiol (bioavailable fraction) in the circulation.
The magnitude of the associations of estrogens with a number of breast cancer risk factors including obesity, reproductive, demographic, and life style factors has been investigated by the Endogenous Hormones and Breast Cancer Collaborative Group in several studies. In a pooled analysis of eight prospective studies in postmenopausal women, adjusting data for free estradiol concentrations attenuated breast cancer risk by 17% for each 5 kg/m2 increase in BMI, resulting in a loss of statistical significance for the association between BMI and breast cancer risk [104]. In another cross-sectional analysis of 13 prospective studies by the same group, estrogen and androgen levels were positively associated with obesity, smoking (15+ cigarettes daily) and alcohol consumption (20+g alcohol daily), and inversely linked with age. By contrast, SHBG concentrations were greater in older women and lower in obese women and those consuming alcohol [105].'
‘The association between circulating endogenous estrogens and breast cancer risk in postmenopausal women has been conclusively established, and compelling evidence exists to support a causal relationship. Epidemiological studies have consistently shown a 2–3 fold increase in breast cancer risk in women with elevated blood estradiol levels. On the other hand, findings from estrogen metabolite investigations are mixed. This inconsistency in estrogen metabolite results may be due to methodological differences in participant characteristics, study design and follow-up length (for some studies insufficient), number of cases (some studies under-powered), and high inter-individual variation in serum and urinary concentrations of estrogen metabolites, or limitations associated with estrogen metabolite measurement. Of particular note are differences in assay methodologies. Until recently, the leading methodology for measurement of estrogen metabolites was ELISA, a method that has limited specificity and sensitivity. This is of particular importance for analysis of samples from postmenopausal women, whose levels are extremely low. Recently, some groups have used liquid chromatography–tandem mass spectrometry (LC–MS/MS), which has much higher sensitivity and specificity.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4505810/#R14
Estrone can exert a role in BC only after being metabolised to estradiol inside breast cancer cells.
'Estrogens play a pivotal role in the development and proliferation of hormone-dependent breast cancer. Apart from free estrogens, which can directly activate the estrogen receptor (ER) of tumor cells, sulfo-conjugated steroids, which maintain high plasma concentrations even after menopause, first have to be imported into tumor cells by carrier-mediated uptake and then can be cleaved by the steroid sulfatase to finally activate ERs and cell proliferation' https://www.frontiersin.org/articles/10.3389/fphar.2018.00941/full
From what I have understood, estrone levels are higher in postmenopausal women, independently of their obesity status. Obesity can further elevate estrone levels (but also estradiol levels), particularly in the peripheral tissues via fat cell metabolism. Thus, any impact of estrone in BC would mean the same for estradiol (endogenous or from HRT).
I'm not aware of any robust studies on BC and estrone, except for the ones that also consider estradiol as a factor.
BeaR.
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Interesting subject. I suggest that you all continue as you are. When I had breast treatment in the 1990s: non-sinister lump found, surgery, changes in the lump margins at histology, bone scan and precautionary radiation for 4 weeks and regular mammos ....... still here! Fortunately I have not required HRT and stopped the 'tamoxifen' as it nearly killed me :-\. It was supposed to be taken to reduce a recurrence but a friend died of womb cancer due to taking it for years. Go figure.
What GPs need to do is to listen to women. Many commit suicide due to menopause symptoms ............ there are risks, even getting out of bed is a risk!!
Maybe decide why you take it. Make a list of how you felt prior and how it has helped. GPs can refuse to prescribe, sadly. Quality of Life! ;)
I was anorexic from age 3, diagnosed at age 5. At my lowest, in 1971, I went down to slightly over 5st. I ate enough to remain upright. Never obese. But I grew a lump which had cancerous changes within it. Never smoked. Don't drink. Exercised well until 5 years ago .........
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I wonder what side effects they are referring to with norethisterone, it is really bad to take for some people,i had awful diarrhea and lost loads of hair on it within 4 weeks of taking it
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interesting comments by Kirsty Lang in mirror today
katy
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https://www.mirror.co.uk/3am/celebrity-news/kirsty-lang-reveals-shes-restarted-19435620
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"With an average use of 10 years of MHT in current users at diagnosis, and 7 years in past users, much of the exposure to MHT preceded the first publication of the Women's Health Initiative study, after which prescribing practices changed substantially. Consequently, virtually all of the included information pertains to MHT formulations and doses known to have adverse breast effects that are no longer recommended. Specifically, the use of the progestogens medroxyprogesterone acetate and norethisterone (norethindrone) is now discouraged because of their known adverse effects, but these account for nearly all of the data for combined estrogen-progestogen therapy included in the paper.
I had no idea norethisterone is no longer recommended and now discouraged. (!)"
Anyone who is using evorel sequi or evorel conti will be using norethisterone. This treatment was recommended to me at a menopause clinic. I want to know what adverse effects are being referred to and whether I should consider other options when any become available.
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Butterfly22, just a little update as we were chatting about bone health. I just had my results. Apparently normal for my age. Consultant says normal range for hip and borderline osteopenia for spine.
No medication needed. I asked if they prescribe hrt normally and that was a no. They prescribe different medication and I was told I don't need it, but I must manage my dietary/lifestyle choices and do weight bearing exercise. Walking was recommended as it's weight bearing for spine.
They would have prescribed me calcium and vit d if I was low but my blood test showed good levels. I will have another scan in 2-3 years. X
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So does anyone actually understand what we are being told? How GPs are likely to react?
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They won't just react, they will over-react - without adding one once of common sense! ;D I'd stake my house on it from the one's I met and the stuff they already get up to which gets posted on here! Its well known here how I just love them! :-X
I do CKLD - its what you said "quality of life", and what Kirsty Lang said "what's the point of having a life if you are miserable" an it should be about "choice". xx
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Just received letter from GP telling me to go urgently for mammogram!!
I have made appointment 9am next Monday to see GP!
I have read the Lancet paper (research behind the headlines).......she will have read the daily mail ! Hopefully it is not that ridiculous.
Lots of brilliant people have tried to explain the reality of the risks in response to the alarmist headlines in the press and tried to add much needed perspective.
KatyX
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Hello ladies
BeaR - excellent post, thank you.
Katy60 - wishing you well and keep us updated.
Take care ladies.
K.
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Thanks Kathleen and stellajane
Dr Currie has posted the joint response from BMS and RCOG on home page.
Anyone worried please read!
KatyX
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I guess time will be the answer. As many more women take hrt now, they will start to see over the next decade, what will be the outcome. Hopefully by then they will have a clearer picture, but it's good they carry on with all this research in the meantime. 👍
Hi Jari,
Agree. Well-balanced view. Sums it up brilliantly.
BeaR.
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Hear Hear Stellajane - but I am not convinced...just when I thought we were actually getting somewhere with all the press about meno and drugs and work and Diane's petition which would counteract all the nonsense we encounter as menopausal womenmalong comes basically a rehash of an old research paper that is full of if's and buts and maybe's which we have only just got rid of, following the last discedited paper. I am normally a rational positive minded person all for progress...well I thought we were progressing but from what I have learned on this issue, there are enough uneducated medical professionals out there without them having more ammunition, that they don't really understand to spout when we present in a total state of anxety.
It is such a controversial issue that I am surprised that it has been given the airtime and Lancet space when none of what has been printed is conclusive in any way. You need facts to make choices not "maybe's".
My mum used to say "unless you have something really useful to say, say nothing". I wish this had applied in this case.
Is a bit like the shortages....put it all over the papers and panic people and the shortages get worse...big surprise! How to make worried people more worried...this is another prime example. Sorry if I sound cross but in my book printing "maybe's and we will have to wait and see" smacks of carelessness towards menopausal women!
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We are really lucky as we know how to access the best info to get a balanced view of this headline. I think most of us will just ignore it and carry on.
Can you imagine the poor ladies (and gps to be fair) who have only read the newspapers and take it as gospel. There will be so many now who are either too scared to start hrt or will just stop taking it altogether. I find it incredibly sad that we will inevitably get another generation of women who suffer for the rest of their lives because of this.
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It seems that many ladies are really upset and worried with possible repercussions, if GPs/NHS change their view/policy on the prescription of HRT, based on this study (not the headlines, please).
Even it if happens, it's unlikely that GPs will ask you to stop HRT. These are general guidelines for public health policy, but there are also specific guidelines for individuals, that NICE and Menopause Societies are probably revising as we speak, and they will address the many cases when HRT is necessary (premature ovarian insufficiency, surgical menopause, familial history of osteoporosis). For those women who have debilitating symptoms that are not regarded as specific medical conditions related to hormone deficiency, i.e. natural menopause, HRT will still be recommended when other approaches have failed. Each woman, as an individual, has a different medical history, and considering that menopause can affect underlying conditions, in the end, there are many other factors that will be taken into account when deciding for the use of HRT.
I personally don't think there will be a significant change for individual cases.
Another paper (also analysing data from an Oxford study) have hit the headlines this week, ‘Vegans and vegetarians may have higher stroke risks' https://www.bbc.com/news/health-49579820 . If you read the actual study https://www.bmj.com/content/366/bmj.l4897 and the commissioned article ‘Report of an increased stroke risk should be explored by researchers and kept under review for guidelines' https://www.bmj.com/content/366/bmj.l5272' you won't notice anything out of the ordinary. There are no vegans and veggies feeling outraged by the study. I'm vegetarian and I won't start eating meat because of this study. Being vegetarian must have risks, the same goes for taking HRT, but both have benefits, lower rates of ischaemic heart disease for vegetarians, better quality of life for HRT users. Everything in life comes in packages, full of good and bad things. Nothing is perfect.
I honestly think that GPs are not going to crucify HRT as it happened after the WHI trial, for the simple reason that there's a lot more information available and more importantly, accessible, now. Not only for GPs but for patients as well.
BeaR.
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Some good posts and links on the feed.
One of the other potential risks for BC that I believe is severely underestimated is under arm deodorant usage, especially sprays (and to a lesser extent body lotions if applied to the breast and fabric conditioners from washing clothes), especially if they contain methyl/propyl parabens as a preservative which is a known carcinogen.
This is one area that never gets scrutinised, no doubt cos of the financial interests involved within the cosmetics etc industries.
Where does it stop!!!!
Rhiner
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Hey, but men get BC too. Where's theirs coming from?..!
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Good point Rhiner, I use a crystal deodorant. It's a tip my friend with breast cancer gave me, never to use aerosol which are full of chemicals x
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Hey, but men get BC too. Where's theirs coming from?..!
Hi orrla,
https://www.breastcancer.org/symptoms/types/male_bc
Risk factors https://www.breastcancer.org/symptoms/types/male_bc/risk
Hope this helps,
BeaR.
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Interesting point orrla, personally I think the increase in gynaecomastia and mens breast cancer is due to the hormones in our water that can never be fully eradicated and in plastics which also are in our water. Plus there is the alcohol factor.
By the way I started posting before Bear put down mens risk factors..ooops!
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Age! ..and obesity, again. But I did not know that obesity increases production of estrogen..
Interesting.
Thanks!
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You're welcome.
I did know that obesity increases the production of oestrogen, but I didn't know that 'being heavy users of alcohol, which can limit the liver's ability to regulate blood estrogen levels'
Always learning!
BeaR.
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I remember learning the large amount of alcohol/liver function/man boob connection at school. There are probably similar repercussions for women, but at lower intake.
I suppose one needs to look after ones liver, which brings us back to healthy diet and exercise ;)
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I remember learning the large amount of alcohol/liver function/man boob connection at school. There are probably similar repercussions for women, but at lower intake.
I suppose one needs to look after ones liver, which brings us back to healthy diet and exercise ;)
Yes, what I didn't know was that alcohol is involved in regulating blood oestrogen levels. Of course a bad liver won't be able to metabolise anything at the same rate as a healthier liver, but I understood that alcohol can directly affect oestrogen metabolism. Must investigate it.
BeaR.
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Hello ladies
BeaR - there are are at least two vegan supporting people commenting online. Mic the Vegan is one, plus Dr Neal Barnard. I think that one way the liver regulates oestrogen is by sending any excess into the colon where it binds to fibre and is excreted. Problems occur when there is insufficient fibre and oestrogen lingers in the colon and is reabsorbed thereby raising levels.
The main source of consumed hormones is in meat and dairy. We have bred cows that are capable of lactating whilst pregnant, something Mother Nature would never normally allow.
Take care ladies.
K.
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This is really interesting. Our organs are amazing. I will look up those names Kathleen.
A book, I have somewhere is called, You are what you eat.. so much truth in this! Not literally obviously. ;) but you know what I mean. X
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Hello ladies
BeaR - there are are at least two vegan supporting people commenting online. Mic the Vegan is one, plus Dr Neal Barnard. I think that one way the liver regulates oestrogen is by sending any excess into the colon where it binds to fibre and is excreted. Problems occur when there is insufficient fibre and oestrogen lingers in the colon and is reabsorbed thereby raising levels.
The main source of consumed hormones is in meat and dairy. We have bred cows that are capable of lactating whilst pregnant, something Mother Nature would never normally allow.
Take care ladies.
K.
Thank you, Kathleen!
I found Dr. Barnard's YouTube video https://youtu.be/qHYqkglFdPY
Is Mic's comment on Twitter? I don't have an account. Found it! https://www.youtube.com/watch?v=LFAOdAmGoho
BeaR.
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https://www.gov.uk/drug-safety-update/hormone-replacement-therapy-hrt-further-information-on-the-known-increased-risk-of-breast-cancer-with-hrt-and-its-persistence-after-stopping
This is from the MHRA. Someone has posted a letter from their GP from MHRA on Mumsnet but it is a photo so I cannot reproduce it here.
Does anyone know how this squares up with NICE and BMS, RCOG etc?
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..so we will all die of old age anyways...
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Yep. ;D. Something will carry us off ..........
The issue of deodorants was put into the bin many years ago ;-). Otherwise they would have been withdrawn from sale ........... no one suggested that because I used anti-perspirants to stop sweating and deodorants to keep my under-arm areas, was the reason that my breast developed cancerous changes. I note that both are still on the shelves with no apparent warnings about BC :-\.
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https://www.newsonhealth.co.uk/news/british-menopause-society-uses-freedom-of-information-act-to-question-mhra-practices
I saw this article on twitter, about the MHRA letter sent out to GPs.
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Tnx but what is MHRA - :-\
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Medicines and Healthcare Products Regulation agency (where is the P? ::) ??? )
https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency
They sent an urgent e-mail to GPs reiterating the smallest amount for the shortest time etc.
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Have you listened to the recent podcast? Dr Newson discusses some of this with Diane. I think all of this is a bit of a slap in the face for them after all the hard work they do banging the drum for better meno care for both physical and emotional symptoms. They are clearly, and quite rightly in my humble opinion, really cross about all of this.
I'll be interested to hear the outcome of their FOI request.
Seems like this will run and run. Thank god somebody is fighting our corner xx
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What a great piece written by the BMS to the MHRA, as folks have said GPs will be obeying the new MHRA dictate now!!
I emailed the MHRA re the shortages around the 22nd August, as yet I still wait a reply to the query!!! They replied saying that they had received the letter and would be responded to in 18 days!!!
Rhiner
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Tnx dahliagirl
'dictate' - good choice of word :medal:
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https://www.newsonhealth.co.uk/news/british-menopause-society-uses-freedom-of-information-act-to-question-mhra-practices
I saw this article on twitter, about the MHRA letter sent out to GPs.
Thanks for this dahliagirl - so glad they have done this. I did find it strange and commented to this effect after Emma posted the link to the IMS response - why this updated "guidance" was produced so quickly.
I have an appt with my GP (gynae specialist) next week so will be interested to hear her take on it or even if she mentions it! Must remember to print out Louise Newson's letter as well as IMS/BMS responses!
If you hear anything further let us know! I follow all sorts of meno stuff on Twitter but there are so many different platforms to check I don't have the time to see them all so thanks for informing us here!!!
Hurdity x
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Gps will immediately read the flaming mhra but seem to have been completely unable to read the nice guidelines for the last 4 years!
It's a shame that professionally nobody can hint at the elephant in the room about the hrt shortage / the timing of this report.
X
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Oh...I'm with you Bobidy - drives me nuts!
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I don't think this one has been put up yet - this is the BMS response to the recent MHRA recommendations which precedes their later letter re Freedom of Information, which dahliagirl posted yesterday and is additional to their response to the Lancet paper before the MHRA issued their hastily prepared updated guidance:
The medical advisory council of the BMS has reviewed the recommendations issued by the Medicines and Healthcare Products Regulatory Agency (MHRA) on 30 August. The following letter was sent to Dr June Raine, interim CEO of the MHRA
https://thebms.org.uk/2019/09/bms-response-to-mhra-recommendations/
Hopefully I'm not duplicating anything!
Hurdity x
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Another article published putting the Lancet Study into perspective - this time in Australia written by Professor Susan Davies, who amongst other roles is president of the International Menopause Society.
The article is entitled "Menopausal hormone therapy and breast cancer: no need for panic"
https://insightplus.mja.com.au/2019/35/menopausal-hormone-therapy-and-breast-cancer-no-need-for-panic/
Hurdity x
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Very interesting article Hurdity, many thanks for sharing.
Rhiner
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Hurdity - thanks for posting the link to the BMS response to the new MHRA recommendations. A tense time for those of us wondering what our next GP contact will bring.
Wx
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Maybe make appts earlier than usual? If necessary with the Practice Nurse or Manager?
Interesting that the articles have been 'taken' from other research and not independent recent information! But of course, the media jumped on2 it >:( ....... must have been a slow news week?
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Intending to keep a low profile at GP surgery until this blows over CLKD! My HRT is prescribed by a top consultant, so with any luck GP will not feel it's her responsibility to review.
Wx
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I'm going to do the same as you wrensong and give a wide berth as my gp before I went on hrt kept reiterating how I would be at risk of breast cancer x
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Countrygirl, my GP surgery always said no HRT after 60, so the future has been a worry from day 1. A few years to go yet, but I imagine their position has not softened recently. Had many a tense discussion with my former GP (now retired) who told me outright she was anti-HRT, though she didn't need to, as her disapproval was obvious! I had a lot of sympathy with her position and disliked going against her as she had been otherwise good to me & we got on well, but, as for so many women, my life was being wrecked by the menopause from hell. Had she been similarly severely affected & over a long period of time, I imagine her view would have been different. The thing I found most odd was that she seemed to know little about menopause & even less about HRT. As she was the only female practice member in a town with only 1 surgery, I thought that surprising. To say the least! This widespread ignorance about menopause from those we have no choice but to go to for help & the opposition so many of us encounter, makes what is already a very difficult time so much harder, more painfully emotional & more stressful. It simply should not be this way. Thank goodness for those like Louise Newson who are working hard to raise the profile of menopause, dispel myths & advocate for the female 50% of the population (not a minority last time I looked), who have a right to expect the most effective & appropriate treatments during what may be several decades of our lives.
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No GP should put their private view points forwards so that it excludes apprporpaite prescribing. What happened to the Hypo?? Oath. They are supposed to work for the patient. Would they refuse to prescribe for a diabetic preferring to recommend a change of diet :cuss:
Life is a risk. I fell off my mules this morning :-\
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https://www.menopausedoctor.co.uk/news/british-menopause-society-uses-freedom-of-information-act-to-question-mhra-practices
KatyX
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To be fair, she did not prevent me taking HRT CLKD, but repeatedly stated that the surgery's position was not to to support HRT use for women over 60. Not sure what this would mean in practice & I dreaded any conflict that might arise as a result. Still do. I bypass that eventuality by going elsewhere for my menopause prescribing, but feel none of us should need to. I appreciate that GPs are very busy indeed & cannot be expected to have extensive knowledge of every medical condition, but when it's something that adversely affects such a large proportion of the population & patients sometimes cannot access specialist help without a GP referral, it is a very regrettable situation.
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Katy60, thank you for posting the link - I already had it bookmarked together with a whole library of others, but it is very appropriate that you posted it here!
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A news item -
BMJ Editorial: HRT and breast cancer risk - we must prevent another setback in women's health.
link to news item (https://www.menopausematters.co.uk/newsitem.php?recordID=207/BMJ-Editorial-HRT-and-breast-cancer-risk)
"(the Lancet study) included only the data from this publication and did not mention benefit in terms of bone loss and providing protection from cardiovascular disease.
Nor did it mention that there was no increased risk of death from breast cancer or all causes.
The alert has caused considerable anxiety, particularly in women who go through the menopause before the age of 40 and have a higher risk of early death and heart disease if left untreated."
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Thanks Emma
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"Public anxiety After the Lancet study was published, the Medicines and Healthcare Products Regulatory Agency (MHRA) issued a drug safety alert to all doctors to communicate the breast cancer risk to women considering or taking HRT. It included only the data from this publication and did not mention benefit in terms of bone loss and providing protection from cardiovascular disease. Nor did it mention that there was no increased risk of death from breast cancer or all causes. The alert has caused considerable anxiety, particularly in women who go through the menopause before the age of 40 and have a higher risk of early death and heart disease if left untreated."
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Thanks Emma (and dahliagirl for expanding on the news item).
Hurdity x
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Thank you Emma.