Menopause news

HRT News - good and bad

4 August 2009

Risks and benefits of the use of Hormone Replacement Therapy (HRT) continue to be reported and debated. Two recently reported studies have suggested two quite different interesting effects of taking HRT.

The first is a nationwide Danish study which reported an increased risk of ovarian cancer in women using HRT. 909,946 Danish women aged 50 to 79 were followed up from 1995 to 2005. Compared with women who had never taken HRT, women who were currently using HRT had an increased risk of ovarian cancer, regardless of type of hormones used or duration of use. In women who had previously used HRT, by 2 years after stopping, the risk had returned to baseline. The actual increased risk approximates to 1 extra ovarian cancer for around 8,300 women taking HRT per year.

Comment

The Million Women Study also previously reported an increased risk of ovarian cancer with the use of HRT, an association which was a surprise to many of us. So far no biological explanation has been given for this association and it is unclear why, if indeed an association does exist, should the risk decrease so quickly after stopping HRT. We must continue to be aware of this possible association, but must also keep this risk in perspective; the magnitude of 1 extra per 8,300 women per year is extremely rare, (a magnitude of risk of less than 1 extra per 1,000 being considered rare), and must continue to balance possible risks against known benefits. For many women with troublesome menopausal symptoms or premature or early menopause, the benefits of HRT will continue to outweigh the risks.
Reference [48] >>

The second study of interest is a French study which followed up 63,624 postmenopausal women; the study is known as E3N cohort study. Previous reports from this cohort have looked at risk of breast cancer and venous thrombo-embolism (blood clot) with use of HRT but this recent report showed a reduced risk of new-onset diabetes among women who had ever used HRT compared with women who had never used HRT. This reduced risk was demonstrated regardless of Body Mass Index (calculation from height and weight). HRT which was taken in tablet form was associated with a greater reduction in risk for the development of diabetes compared to HRT taken via the skin (patch or gel).

Comment

The previously reported Women’s Health Initiative trial showed a reduced incidence of type 2 diabetes in women taking tablet form of HRT compared to women taking placebo (inactive tablet). This further study confirms these findings. With the incidence of diabetes increasing, this suggestion of a protective effect from the use of HRT could be of major importance. There is insufficient evidence available as yet to recommend the use of HRT purely for this reason, but further studies are desperately needed.
Reference [49] >>

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