Rethinking hormone replacement therapy



Study calls for rethink on HRT

A landmark study, backed by the American Cancer Society, may force a re-evaluation of the use of hormone replacement therapy (HRT), especially among the over 55's.

The study has confirmed earlier worries that artificial hormones can increase the risk of breast cancer, and the risk increases in the over 55's if they have been taking HRT for more than five years.

It has also established that combining oestrogens with progestogens does not offer any protection against breast cancer, even though evidence suggests the combination can protect against endometrial cancer, normally caused by oestrogens alone, the study says.

The study is one of the first to evaluate the risks involved of using the combined hormones.

The study effectively endorses findings of early European studies, but commands special attention because of the sheer size of the study group and because it has been produced by Harvard Medical School, and backed by the ACS.

They studied health reports from postmenopausal women in the Nurses Health Study, which represents 725,550 man years of followup; 1,935 cases of newly-diagnosed breast cancer were recorded.

Researchers discovered that the risk of breast cancer was significantly increased among women who were using oestrogen alone, or oestrogen plus progestogens, against those who had never taken HRT. Women who had been taking HRT for more than five years were at greater risk.

They also found that protection against osteoporosis diminished after women stopped taking HRT, even if they had been on the hormone for longer than seven years.

"Women over 55 years of age should carefully consider the risks and benefits of oestrogen therapy, especially if they have used oestrogen for five years or more", conclude the researchers.

"The significant increase in the risks of breast cancer and of death...suggests that the risks and benefits of hormone therapy among older women should be carefully assessed" - which in the neutral tone of scientific papers amounts to a virtual damnation (New England Journal of Medicine June 15, 1995).

Article copyright The Australian Traditional-Medicine Society Ltd.

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