Lizzy Buchan: Women should not be afraid to discuss HRT

New research suggesting the risks around hormone replacement therapy (HRT) have been underestimated is likely to cause a few hearts to sink.
Hormone Replacement Therapy was once hailed as a wonder drug. Picture: TSPLHormone Replacement Therapy was once hailed as a wonder drug. Picture: TSPL
Hormone Replacement Therapy was once hailed as a wonder drug. Picture: TSPL

The medication was once hailed as a wonder drug for its ability to help women cope with difficult symptoms of menopause, such as hot flushes and migraines, as it tops up flagging oestrogen levels.

However, a number of studies have linked HRT use to an increased risk of cancer in recent years, consigning the treatment to more than decade out in the cold.

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Many women swiftly ditched the pills out of fear of the risks involved, so now only one in ten women takes HRT.

Scottish researchers also published a study last year where they flagged up the worrying fact that lots of GPs were afraid to prescribe or even discuss HRT with patients because of the years of controversy.

Just when it looked like HRT was staging a comeback, a major new study published this week revealed that the link to breast cancer may be stronger than originally suggested.

So what do we actually know?

The robust study published in the British Journal of Cancer uses data from nearly 40,000 women over six years.

For the lay folk among us, the research shows that using combined HRT – containing both oestrogen and progestogen hormones – increased the risk of breast cancer by 2.7 times compared to those who had never taken it.

The risks also rose with the length of use, so women who had used combined HRT for over 15 years were 3.3 times more likely to develop breast cancer than non-users.

Women using oestrogen-only HRT saw no overall increase in breast cancer risk compared with women who had never used HRT.

The risk level returned to normal a year or two after women stopped using HRT.

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These findings may seem concerning but it is important to place them in context, as HRT still has a lower cancer risk than smoking or being obese.

Unfortunately breast cancer is a relatively common disease, with more than 4,600 Scots diagnosed every year. There are myriad risk factors, including genetics and good, old fashioned old age that are out of our control.

What is most concerning is that half of women never consult their GP about the symptoms they suffer through the menopause, according to a report by the British Menopause Society.

The menopause can be devastating for many women, who are knocked sideways by night sweats, crippling headaches and mood swings.

It is simply not an option for them to soldier on without treatment, nor should they have to suffer in silence.

Scottish menopause expert Dr Heather Currie, from Dumfries and Galloway Royal Infirmary, rightly said that the best option would be different for each person.

She said: “For many women, any change in breast cancer risk is outweighed by the benefit on their quality of life, bearing in mind that there are many other factors that increase the risk of breast cancer, for example lifestyle factors.”

We should be grateful for the further insight this new research presents but we should not be frightened by it.

Both women and their doctors should be able to discuss the options sensibly, rather than being afraid to seek help.