Hormone Replacement Therapy

What Are The Risks Of Hormone Replacement Therapy (HRT)?

A major risk of estrogen treatment is blood clots in the veins, and pulmonary embolism, which is the movement of these clots to the lungs. These are rare but serious problems. If a woman has ever had a deep vein clot or pulmonary embolism, she should not use estrogen without a careful evaluation by her doctor.

Most experts agree that taking hormone replacement therapy for five years or less poses little or no danger. This can be long enough for women who simply want a short-term measure of relieving unpleasant menopause symptoms.

Many experts believe the benefits of hormone replacement therapy may be greater than the risks. The best advice is to discuss potential benefits, risks, and side effects with your doctor.

Many of the questions about hormone replacement therapy address these areas:

The Question About Breast Cancer

Breast tissue is highly sensitive to estrogen and progesterone. Some experts believe that the longer a woman is exposed to these hormones, the higher her risk for developing breast cancer.

The link between breast cancer and hormone replacement therapy is the subject of intense debate and many clinical studies.

  • A report in the February 2000 issue of the New England Journal of Medicine concluded that women whose body-mass index is considered “lean” were at increased risk for breast cancer. The study concluded that breast-cancer risk did not increase for heavier women, however.
  • A major 1997 analysis of 51 studies indicated that even one year of HRT could increase the chances of breast cancer.
  • Many studies indicate that the danger of breast cancer exists only with long-term hormone replacement therapy (more than five to eight years).
  • Studies show an increase in breast cancer among women taking HRT only if they consumed one or more alcoholic drinks a day.
  • Studies have shown that any extra risk of developing breast cancer declines quickly once HRT is stopped.
  • Other studies have shown no significant increase in breast cancer among women who take HRT.

Some experts point out that even if HRT does increase the risk for breast cancer, tools for early detection of breast cancer (such as mammography) can pinpoint cancer at its earliest and most easily treated stages.

They suggest that if women perform monthly breast self-examinations and have annual mammograms, breast cancer can be identified and successfully treated.

Women with previously diagnosed breast cancer or those with a first-degree relative (such as a mother or sister) with breast cancer need special consultation with their physicians before taking estrogen.

Other Potential Concerns

Other possible negative effects of HRT may include:

  • Asthma. Women who take HRT have a slightly higher risk for developing asthma later in life; however, the chances are extremely small.
  • Gallstones. Women who take high doses of estrogen are at higher risk for developing gallstones. Low doses of estrogen do not increase risk of developing this common condition, however.
  • Changes within the uterus. HRT may aggravate a painful condition called endometriosis or may cause fibroids to grow.

For further information about endometriosis, go to Endometriosis.

For further information about fibroids, go to Fibroids.

Need To Know:

Your doctor may recommend that you not take HRT if you have:

  • High blood pressure
  • Diabetes
  • Liver disease
  • Blood clots
  • Seizures
  • Breast cancer
  • Migraine headaches
  • Gallbladder disease
  • A history of cancer
  • A mother who took DES (diethylstilbestrol) during pregnancy. DES was given to women from the 1940s through the 1960s to prevent miscarriage, and it later was found to cause changes to the reproductive system in the daughters of women who took it.


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