Hormone replacement therapy (HRT) is the use of oestrogen, or oestrogen + progestogen to control symptoms that may occur at the menopause (‘change of life’), for example hot flushes, sweats and vaginal dryness
HRT was the most effective treatment for hot flushes and other menopausal symptoms in the early 2000s but some medical research began to suggest that it caused harm and people’s attitudes to HRT changed. However this medical research has recently been reviewed and ‘Most experts agree that if HRT is used on a short-term basis (no more than five years), the benefits outweigh the risks’ (NHS Choices 2014).
As with any medication, HRT has benefits and risks and these should be discussed with your doctor as it may not be suitable for everyone. HRT is not recommended for women who:
- have a history of breast cancer, ovarian cancer or womb (uterus) cancer
- have a history of blood clots
- have a history of heart disease or stroke
- have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
- have liver disease
- are pregnant
Several women we spoke with were wary of media reports about HRT and breast cancer and had discussed the pros and cons with their doctors.
Some women were taking or had been taking HRT to relieve menopausal symptoms or to protect against osteoporosis. Several talked about its benefits for menopausal symptoms and recommended it to others, though some had gained weight whilst taking it. One woman had taken HRT for ten years and said it had helped with her day and night sweats. A nurse who had used HRT for some years said that, for her, the low risk of getting breast cancer was outweighed by the benefits of taking HRT. Another woman, whose mother had died of breast cancer, said her GP emphasised the importance of attending for breast screening because of the risks of HRT. She stopped taking HRT for a while but felt ‘miserable’ off it and asked to take it again. One woman had depression and panic attacks during her menopause, which went away with HRT. She was now scared of stopping it.
HRT helped with her day and night sweats.
She felt miserable when taken off HRT so asked to take it again but with regular screening.
She had depression and panic attacks during her menopause and is too scared to come off HRT.
Several women had been on HRT but were no longer taking it. Some stopped taking it when the menopause ended. One said her consultant felt the cysts she’d had in the past might have been caused by HRT. She was no longer taking HRT and said she could live with the mild hot flushes she occasionally had. Another woman stopped taking HRT after 18 months because her blood pressure had risen. After a year on HRT, one woman tried a herbal treatment which worked just as well without causing weight gain. She preferred Wild Yam Root to HRT, and recommended it to other women.
She is no longer on HRT, which might have caused her cysts, and can live with her mild hot flushes.
She stopped taking HRT after eighteen months because her blood pressure rose.
She took HRT for a year and then changed to a herbal remedy that she recommends to other women.
Delfina was on HRT for several years because she had severe hot flushes. When, on holiday, she…
A few women who’d had breast cancer wondered if HRT had caused it, and one said she needed to blame her cancer on something and put it down to HRT. Another wondered whether stress had played a role. One woman, who’d had an early form of breast cancer (Ductal carcinoma in situ or DCIS), had stopped taking HRT for osteoporosis and wondered if this had eliminated her risk of getting DCIS again, which HRT might have caused. She had since been prescribed calcium tablets for her bones and wondered why she hadn’t been prescribed these earlier as doctors knew that HRT carried a breast cancer risk.
She took HRT for brittle bones and feels it might have caused her breast cancer.
She needed to blame her cancer on something and put it down to HRT.
All the women who took HRT and were later found to have breast cancer were advised to stop taking it after their diagnosis. Most did not take HRT again, but one asked to go back onto HRT because it greatly improved her quality of life, and her doctors agreed. Another, who’d had Paget’s disease (a rare cancer of the nipple) and DCIS, said that she’d been prescribed HRT for five years without really being monitored until she changed GP. Her new GP suggested she come off HRT.
She restarted HRT after surgery for breast cancer, with the consent of her consultant because it…
Her HRT hadn’t been monitored and she stopped taking it when she changed doctor.
Some people had chosen not to take HRT, despite it being recommended by other women. One woman whose mother had had osteoporosis refused to take HRT because its long-term effects were uncertain. A few others said they would like more information about HRT and its long-term effects.