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Cancer News in Context
Estrogen-Alone, But Not Forgotten
(July 17, 2006) Just when you thought you’d heard enough about postmenopausal hormones, another big Women’s Health Initiative study was released this spring, this time looking in detail at the breast cancer risk linked to long term use of postmenopausal hormones that contain estrogen alone—the type of hormones most often used by women who don’t have a uterus.
The study found that after seven years of follow-up, estrogen-alone did not increase the risk of breast cancer. It did, though, make it more likely that women would be called back for follow up tests after their regular screening mammograms. It wasn’t clear why this was. One likely reason is that hormone use increases breast density, making it more difficult to get clear views on a mammogram. And follow up tests like ultrasound, biopsy, or further mammograms were needed to rule out any potential problems.
So, aside from the potential for extra follow up tests, are estrogen-only hormones breast safe? Well, it’s still not perfectly clear. The Women’s Health Initiative followed women for seven years, and since the study has been stopped, data won’t be available on longer term use. However, a new Nurses’ Health Study report that came out on the heals of the Women’s Health Initiative findings, strongly suggests that there still may be some breast cancer risk after more than 15-20 years of estrogen-only hormone use.
Of course, breast cancer is only one of a number of important considerations when it comes to postmenopausal hormones.One thing that’s clear when all the evidence is looked at together: postmenopausal hormones shouldn’t be taken long term to prevent chronic diseases like osteoporosis and heart disease.
The Women’s Health Initative has shown that estrogen-only hormones don’t lower the risk of heart disease, and actually increase the risk of stroke. And estrogen plus progestin hormones—the type of hormones taken most often by women with a uterus—raise the risk of heart disease, stroke, blood clots, and breast cancer.
While both types of hormones lower the risk of osteoporosis, this benefit is usually offset by their risks, especially since there are many other options for combating bone loss and fractures.
Whether women should take postmenopausal hormones in the short term to treat menopausal symptoms like hot flashes is a personal decision.Hormones can bring significant relief from unpleasant, irritating, and sometimes severe symptoms, and the risks are relatively small from 1- 2 years of hormone use, especially for estrogen-alone in women without a uterus. If women do take hormones, it should be for the shortest time possible.
As always, the best person to talk to about the risks and benefits of postmenopausal hormones is a doctor.
—Written by Hank
Dart
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