Younger Women May Benefit From HRT
Study Shows Benefits When HRT Is Taken Soon After Menopause
Breast Cancer Risk
So who should take HRT and for how long? As University of Florida Health Science Center ob-gyn Andrew Kaunitz, MD, explains, the answer is not a simple one.
Kauntiz tells WebMD that most, but not all, women should consider combination hormone therapy only for the relief of menopausal symptoms such as hot flashes. The one exception, he says, is women without uteruses who might be candidates for long-term estrogen-only hormone therapy to prevent osteoporosis.
That is because the WHI and other large studies suggest that it is the progestin and not the estrogen in combined HRT that increases breast cancer risk. Since women who have had hysterectomies take estrogen-only hormone therapies, long-term treatment may convey fewer risks for them.
"Breast cancer is the main thing my patients are worried about, " Kaunitz says. "The studies do indicate a small increase in breast cancer risk with the long-term use of combination therapy, but this does not appear to occur with estrogen-only therapy."
For women with bothersome menopausal symptoms who have not had hysterectomies, decisions about whether or not to take combination HRT should be made on a case-by-case basis, he says.
Salpeter agrees that family history of breast cancer, heart disease, and osteoporosis should all be considered when weighing the risks and benefits of HRT.
"A woman with menopausal symptoms in her 50s who has a mother or aunt who has had hip fractures damned well better be on HRT," he says. "But a woman with a close family history of breast cancer may not feel comfortable taking it."