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Cancer Risk Hormone Replacement Therapy

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Selective Estrogen Receptor Modulators

Hormone replacement therapy and breast cancer risk

The clinically oldest selective estrogen receptor modulator , tamoxifen, acts in breast tissue as an estrogen antagonist and therefore it is used in treatment and chemoprevention of breast carcinoma while its agonistic effect causes endometrial hyperplasia.39

Bazedoxifene is a new SERM that verifiably reduces bone mass loss in postmenopausal women and reduces the risk of vertebral and nonvertebral fractures without stimulating breast tissue or endometrium.40

It can be used for treatment or prevention of osteoporosis in postmenopausal women. It does not stimulate the mammary gland or the endometrium. When used at a dose of 20 or 40 mg per day, it protects the endometrium during systematic estrogen treatment .41

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Is Hrt An Ovarian Cancer Risk Factor

Several cancer research studies have shown that HRT can lead to a slightly higher chance of a person being diagnosed with ovarian cancer.

In 2003, the first study linking hormone medications to ovarian cancer was published. A group of U.S. researchers in the cancer and gynecological fields studied more than 16,000 people who were postmenopausal in 40 clinical centers throughout the country. The researchers assigned each study participant to either take HRT or a placebo . After following up with participants an average of 5.6 years from the onset of a persons participation, ovarian cancer rates were slightly higher in the control group than in the placebo group.

Similar results were reported in a British study of nearly 1 million women published in 2007. Researchers found that people who were currently using HRT were 20 percent more likely to develop ovarian cancer and 23 percent more likely to die from the disease.

It is important to note, however, that a persons risk of ovarian cancer is low to begin with, so ovarian cancer is still rare for those who have used HRT.

More recently, a group of ovarian cancer experts published a report in which they combined data from 52 different studies that analyzed the link between HRT and ovarian cancer. This report also found an elevated risk of the condition among HRT users.

These researchers reported a few key findings:

Taken together, these studies show that though it is a slight one HRT can be an ovarian cancer risk factor.

Perimenopausal Women May Experience A Variety Of Problems

Perimenopause is one of the most difficult times in a womans life. Your body is constantly adjusting to the changing hormone levels over a period of years. Eventually, these hormonal changes begin to reduce the frequency of your periods and at some point, stop them altogether. Once they stop, you enter a full menopausal phase for several months.

Not every woman experiences the same symptoms, but perimenopausal women commonly experience some or all of the following:

  • Hot flashes and heart palpitations
  • Night sweats, migraines and headaches
  • Insomnia and poor-quality sleep
  • Weight gains related to a slowing metabolism
  • Vaginal dryness and pain

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Menopausal Hormone Replacement Therapy And The Risk Of Ovarian Cancer: A Meta

  • 1Department of Reproductive, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
  • 2Department of Gynecology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
  • 3Department of Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
  • 4Department of Oncology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China

Background: Findings by epidemiologic studies on menopausal hormone replacement therapy and the risk of ovarian cancer are inconsistent. This study aimed to assess the association of menopausal HRT with the risk of ovarian cancer by histological subtype.

Methods: A literature search was performed in PubMed, Web of Science, and EmBase for relevant articles published from inception to August 2018. Pooled relative risk ratios with 95% confidence intervals were determined with a random-effects model.

This meta-analysis suggests that menopausal HRT may increase the risk of ovarian cancer, especially for serous and endometrioid tumors.

Hormone Replacement Therapy Lawsuit

Does hormone replacement therapy (HRT) increase cancer risk?

Hormone replacement therapy lawsuits seek monetary compensation for women who have sustained serious health complications from taking HRT drugs, such as Prempro. Prempro is produced by Wyeth Pharmaceuticals . Currently, Wyeth is facing more than 10,000 HRT lawsuits, and has paid out more than $165 million in HRT litigation settlements.

Prescribed for years in the treatment of menopausal symptoms, hormone replacement therapy uses estrogen, progesterone, and/or progestin to minimize hot flashes, night sweats, anxiety, and other menopausal symptoms. It comes in pill form, and it has been taken by more than 6 million women in the U.S.

Serious risks and side effects associated with the use of Prempro became public when, in 2002, the Womens Health Initiative announced that it was ceasing a large clinical study on HRT medication due to findings that the drugs were increasing the risk of breast cancer by 26 percent, of blood clots by 100 percent risk, and of stroke by 41 percent.

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Settlements Outside Of Court

When a legal matter arises between two private parties, settling outside of court often provides a speedier and less expensive resolution to the matter for everyone involved. Settling offers the plaintiff the opportunity to secure a recovery more quickly, albeit the settlement value of a given claim is likely lower than its potential trial value. On the other side, the defendant may offer more than he or she may have expected to pay in exchange for settling the matter quickly.

When two parties agree to a settlement, they very carefully scrutinize the damages involved in a claim and allocate an appropriate amount to each. Different types of damages have different tax implications following the passage of the Small Business Job Protection Act of 1996, which added damages for personal physical injuries or physical sickness to the list of tax-exempt damages in an out-of-court settlement. Since businesses cannot legally suffer personal physical injuries, these tax-related distinctions only apply to settlements awarded to individuals.

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Drugwatchcom Has Been Empowering Patients For More Than A Decade

Drugwatch.com has provided reliable, trusted information about medications, medical devices and general health since 2008. Weve also connected thousands of people injured by drugs and medical devices with top-ranked national law firms to take action against negligent corporations.

Our team includes experienced medical writers, award-winning journalists, researchers and certified medical and legal experts. Drugwatch.com is HONCode certified. This means the high-quality information we provide comes from credible sources, such as peer-reviewed medical journals and expert interviews.

The information on Drugwatch.com has been medically and legally reviewed by more than 30 expert contributors, including doctors, pharmacists, lawyers, patient advocates and other health care professionals. Our writers are members of professional associations, including American Medical Writers Association, American Bar Association, The Alliance of Professional Health Advocates and International Society for Medical Publication Professionals.

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Bioidentical Hormone Replacement Therapy Helps Improve Skin

As we age, our skin tends to dry out and become more fragile, leading to more skin infections, wrinkles, and lines. Studies have shown that using bioidentical hormone replacement therapy can increase skin hydration, thickness, and elasticity.

This result is a more hydrated appearance with reduced fine lines and wrinkles! Reports have also shown that collagen production increases as estrogen levels increase. This is a great way to combat signs of aging on the skin, giving you a younger appearance.

Hormone Replacement Therapy And Cancer

Hormone replacement therapy and potential breast cancer risks

Hormone replacement therapy is often prescribed for women during menopause. Menopause is a natural phase of maturing womanhood, during which the ovaries produce significantly less estrogen, ovulation ceases, and menstruation ends. For many women, menopause has uncomfortable side effects. Hot flashes, sleep disturbances, depression, mood swings and anxiety may affect the menopausal woman. Additionally, menopause may also be accompanied by increased urinary tract infections, incontinence, vaginal discomfort due to a lack of estrogen-based lubrication and decreased bone density. HRT has been effectively used to mitigate these side effects and can be prescribed for women experiencing these unpleasant symptoms of menopause. Results from several clinical studies have demonstrated a correlation between the use of HRT and the development of breast cancer, as well as an increase from death caused by breast cancer.

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Shortage Of Some Hrt Products

There are ongoing supply problems with some HRT products. For some products this is because of irregular supply while for others itâs a longer-term shortage. There are lots of different reasons why medicines can be in short supply. Work is happening with the pharmaceutical manufacturers who make the medicines to help the situation.

If your pharmacy cant supply the specific HRT product youâve been prescribed, they may supply an alternative product. This will usually have the same ingredient, but may be made by a different manufacturer. Your pharmacy might also reduce the amount they provide you with to help ensure that as many woman as possible can get access to their required medication.

Disruptions in the availability of HRT will be worrying if it has been prescribed for you. However, there are always alternative options. If you are concerned about this contact your GP, pharmacist or specialist doctor to discuss the best treatment options for you.

What Are Traditional Hormone Replacement Therapy And Bioidentical Compounds

HRT is generally prescribed for menopausal symptoms. Most standard formulations include both estrogen and progestin components, with both the estrogen and the progestin being in a synthetic form. Conjugated equine estrogen and ethinylestradiol are commonly used estrogens medroxyprogesterone acetate or norethisterone acetate are common progestins used in these formulations. Estrogen-only HRT can be prescribed, but only for women who have previously undergone surgical hysterectomies.

Because of concerns about potential health effects of using synthetic-hormone based HRT, many women have moved to taking Bioidentical Compounds , or compounds that contain estradiol and progesterone, chemicals that are normally produced by the ovary across the normal menstrual cycle, but are actually synthesized from plant estrogens for use in BiCs.

While the components of traditional HRT are described by pharmaceutical companies on packaging in the formulations, BiCs have varying formulations, sometimes being custom-mixed for an individual woman.

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Excess Numbers In Hrt Users

The crude incidence rate of breast cancer in the underlying CPRD cohort was 33.0 per 10000 women years, whereas the crude incidence rate in women not exposed to HRT was 31.5 per 10000 women years. The rate for unexposed women varied with age, with the lowest rate in younger women . The highest rate in the 60-69 years group was consistent with national data from cancer registration statistics in England.22

Table 2 and fig 7 contain incidence rates and excess rates of breast cancer in users of HRT at different ages and for different durations. The number of extra cases is consistently larger for older women for all exposures. Compared with never users, the estimated number of excess cases per 10000 women years in recent long term users of oestrogen only treatment was three in women aged 50-59, four in women aged 60 to 69, and eight in women aged 70-79. Compared with never users, the number of excess cases per 10000 women years in recent long term users of oestrogen-progestogen treatment was 15 in women aged 50-59, 26 in women aged 60-69, and 36 in women aged 70-79. For tibolone in recent long term users, the numbers exposed in younger women were too small to provide sufficient data, but within the older groups there are an estimated nine extra cases per 10000 women years in women aged 60 to 69 and 15 extra cases per 10000 women years in women aged 70 to 79.

Does It Cause Weight Gain

Use of hormone replacement therapy and risk of breast cancer: nested ...

Some people worry that hormone treatment might lead to weight gain, but there is no evidence to support this.

Eating a healthful diet and getting plenty of exercise can help manage the weight gain that commonly affects both females and males in midlife.

There are various ways of delivering hormone therapy, and the different types provide different combinations and amounts of hormones.Common types include:

Estrogen-only HRT: A doctor may recommend this if a person has had their uterus and ovaries removed, in which case progesterone is not necessary.

Cyclical, or sequential, HRT: This may be a good option if symptoms occur before menopause the dosage can align with the menstrual cycle.

Continuous HRT: After menopause, a doctor may prescribe a continuous combination of estrogen and progesterone.

Local estrogen: Vaginal tablets, creams, or rings can help with urogenital symptoms, including vaginal dryness and irritation.

The doctor will prescribe the lowest possible dosage that addresses the persons symptoms, and arriving at this dosage may take some trial and error.

Ways of delivering HRT include:

When a person no longer needs the treatment, the doctor will describe how to stop it gradually.

Various lifestyle adjustments can help manage the symptoms of menopause.

They include:

Also, it is a good idea to ask the doctor about nonhormonal treatment options.

Always speak to a doctor before using any supplements.

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Key Points: Sexual Dysfunction

  • 1. Increase in age and decreased serum estrogen levels lead to harmful effects on sexual function and cause dyspareunia and reduction of sexual desire and sexual response.
  • 2. Measuring the serum level of a sex hormone does not provide much help in diagnosing and treating sexual dysfunction, and conducting a blood test for testosterone to diagnose androgen deficiency in healthy women is not advised.
  • 3. When considering sexual dysfunction, the role of vaginal atrophy should always be considered.
  • 4. Systemic MHT and low-dose vaginal ET are effective for treating urogenital atrophy and improve sexual function by increasing vaginal lubrication, blood flow, and sensory function as well as improve dyspareunia in particular.
  • 5. Regarding female MHT for women with HSDD, percutaneous therapy is preferred over oral therapy and tibolone is effective for treating female sexual dysfunction by increasing womenâs sexual desire and arousal.

Cancers Treated With Hormone Therapy

Hormone therapy is used to treat prostate and breast cancers that use hormones to grow. Hormone therapy is most often used along with other cancer treatments. The types of treatment that you need depend on the type of cancer, if it has spread and how far, if it uses hormones to grow, and if you have other health problems.

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Herbs And Supplements During Menopause

Many over-the-counter natural products are promoted in stores and online as helpful with menopausal symptoms. These include vitamins and soy-based and herbal products . There are also endless arrays of special blends of herbs and vitamins that claim to reduce the discomforts of menopause.

These products are considered dietary supplements . They have not been evaluated by the Food and Drug Administration to be sure that they work or even that they are safe. Some supplements have been tested in small clinical trials, but often the studies only looked at taking the substance for a short time , so it isnt clear how safe it would be if taken for a long time. Another concern has been applying the results of a study of a particular version and dose of a supplement to others that werent tested.

Most of the plain herbs that are touted for menopausal symptoms carry a low risk of harm for most women, but some can interact with other drugs and/or cause unexpected problems. You should discuss herbs or supplements with your doctor before taking them.

Well-controlled scientific studies are needed to help find out if these products work and if they are any safer than the hormone therapy drugs now in use.

What This Study Adds

Does Type of Hormone Replacement Therapy Affect Breast Cancer Risk?
  • The study confirmed increased risks of breast cancer associated with long term use of oestrogen only therapy and combined oestrogen and progestogen therapy
  • The combined treatment associated with the lowest risk increase was estradiol-dydrogesterone
  • The findings suggest lower increased risks of breast cancer associated with longer term HRT use, and a more noticeable decline in risks once treatment is stopped compared with the meta-analysis

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Unanswered Questions And Future Research

In our study protocol we did not prespecify analyses relating to cancer stage or tumour type because these lay outside the main question of interest. Although information on risk related to individual progestogens could be improved, previous studies have shown that the associated risks between HRT and tumour types might differ, with higher risks of developing oestrogen receptor positive tumours and lobular tumours.11 Knowing the cancer stage could also address the question of risk differences between women of various body weights, to clarify whether systematic differences might exist in diagnostic delay. Other unknowns include questions about breast cancer survival rates and all cause mortality in women using HRT.13

Incidence Of Breast Cancer

During a median follow-up of 5.35 years , 26,797 women were newly diagnosed with breast cancer. Among them, 92.9% had invasive breast cancer and 7.1% had ductal carcinoma in situ . The HR of the risk of breast cancer in HRT users was 1.25 compared with HRT nonusers. The results of a multivariable analysis of the incidence of breast cancer according to HRT duration are shown in . The incidence of breast cancer significantly increased with increasing HRT duration. The adjusted HRs for breast cancer incidence in women who had used HRT for < 2 years, 2 to < 5 years, and 5 years were 1.08 , 1.33 , and 1.72 , respectively. This proportional increase in the incidence of breast cancer according to HRT duration was evident in women with invasive breast cancer and those with DCIS . The cumulative incidence of breast cancer was linearly related to the duration of HRT .

Adjusted HRs and 95% CIs of the risk of breast cancer according to HRT duration and invasive/in situ breast cancer.

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