Humana HealthBeat Transcript Archive

While hormone replacement therapy provides many health benefits, estrogen replacement can also increase the risk of uterine and breast cancer. To reduce the risk of uterine cancer, women are advised to take the hormone progestin. But a new study in the Journal of the American Medical Association shows that adding progestin adds additional risk.

Researchers found that the combination of estrogen and progesterone, given on a cyclical basis to copy the menstrual cycle, increases the risk of breast cancer in leaner women. The greatest risk was limited to women who had used hormones in the previous four years or were currently using them.

The longer someone took the therapy, the more their risk increased. According to this study, for every year a woman uses the estrogen-progestin combination her risk of breast cancer increases by 8% compared with a 1% increase among women receiving estrogen only. This is important, because many women take hormone therapy to reduce their risk of heart disease and osteoporosis, which warrants years of therapy.

In an editorial in the same issue, the authors conclude that women who use hormone therapy for the short term relief of menopausal symptoms (i.e., 2 or 3 years) shouldn't be concerned about an increased risk of cancer. They also recommend that women without a uterus should avoid the use of progestin. And for women with a uterus, the risks and benefits of long-term use of hormones should be considered in light of the increased risk of breast cancer and that other alternatives be considered, including other medications and lifestyle changes. For example, exercise, diet, and avoiding tobacco can help strengthen our bones and fight heart disease -with no harmful side effects.

So if you're currently on hormone therapy, or are considering it, speak with your doctor-it's important to put this information in perspective relative to your individual health profile.

January 26
Hormone Replacement Therapy
	While hormone replacement therapy provides many health benefits, estrogen replacement can also increase the risk of uterine and breast cancer. To reduce the risk of uterine cancer, women are advised to take the hormone progestin. But a new study in the Journal of the American Medical Association shows that adding progestin adds additional risk. Researchers found that the combination of estrogen and progesterone, given on a cyclical basis to copy the menstrual cycle, increases the risk of breast cancer in leaner women. The greatest risk was limited to women who had used hormones in the previous four years or were currently using them. The longer someone took the therapy, the more their risk increased. According to this study, for every year a woman uses the estrogen-progestin combination her risk of breast cancer increases by 8% compared with a 1% increase among women receiving estrogen only. This is important, because many women take hormone therapy to reduce their risk of heart disease and osteoporosis, which warrants years of therapy. In an editorial in the same issue, the authors conclude that women who use hormone therapy for the short term relief of menopausal symptoms (i.e., 2 or 3 years) shouldn't be concerned about an increased risk of cancer. They also recommend that women without a uterus should avoid the use of progestin. And for women with a uterus, the risks and benefits of long-term use of hormones should be considered in light of the increased risk of breast cancer and that other alternatives be considered, including other medications and lifestyle changes. For example, exercise, diet, and avoiding tobacco can help strengthen our bones and fight heart disease -with no harmful side effects. So if you're currently on hormone therapy, or are considering it, speak with your doctor-it's important to put this information in perspective relative to your individual health profile.

	Does this information pertain to all women on this combination therapy? There are some limitations to this study. For example, the researchers could draw conclusions about lean women; it's not known how heavier women are affected. The study is also limited to one regimen of hormone therapy; it's not known if giving the progesterone more or less frequently would provide the same results. So, while this is a large study, with good data, there are some unanswered questions that need to be factored into one's decision regarding hormone therapy.