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Medical guidelines say the benefits of HRT, such as quality of life and protection of bone health, usually outweigh the risks. This is especially true for those women who enter menopause at an early age.
The risks are usually very small, and depend on the type of HRT you take, how long you take it and also other factors such as your age and general health.
There are different types of HRT and different ways to take it. The two main hormones that make up HRT are estrogen and progesterone. Estrogen is the key hormone to help improve your symptoms (as most of them are usually caused by a lack of estrogen). The preferred way to take estrogen is through the skin.
Progesterone (or a progestogen) is usually recommended for women who still have their womb and are taking estrogen, this is to help keep the lining of the womb thin and healthy (as estrogen alone can thicken it). You can take this hormone in tablet form or have a Mirena coil inserted into your womb which can remain for 5 years.
Testosterone is a third hormone which some women will need for additional help with symptoms of low libido, lack of energy and poor concentration.
Risk of Breast Cancer with HRT
Medical guidelines say the benefits of HRT, such as quality of life and protection of bone health, usually outweigh the risks. This is especially true for women who enter menopause at an early age. Like most other medical treatments, HRT still poses some risk factors that depend on what type you take, how long for and then age and general health.
3 Types of HRT
The two hormones that we tend to focus on for HRT are estrogen and progesterone.
Estrogen is the key hormone to help improve your symptoms because most people suffer because of a lack of estrogen). The preferred way to take estrogen is through the skin.
Progesterone (or a progestogen) is usually recommended for women who are taking estrogen and still have their womb. This helps to keep the lining of the womb thin and healthy (as estrogen alone can thicken it). Progesterone is available as a tablet or a Mirena coil (which is inserted into your womb and doesn’t need to be changed for 5 years.
Testosterone is the third hormone which we use at BioConnect to help women who need additional help with their low libido, lack of energy or even poor concentration.
HRT and Breast Cancer
Many women worry about the risk of breast cancer when taking HRT but in reality most types of HRT do not increase the risk of breast cancer. This is why BioConnect only works with BioIdentical Progesterone, which has not been associated with an increased risk of breast cancer.
Some studies have shown that women taking combined HRT (estrogen and synthetic progestogen may be associated with a small increased risk of breast cancer but this increased risk is related to how long you take HRT and it falls after you stop taking it. BioConnect doesn’t use synthetic progesterone and specifically only recommends bioidentical progesterone.
Let’s be clear though. Drinking a couple of glasses of wine every night or being overweight both increase the risk of breast cancer more than synthetic progesterone would.
No studies have shown that any type of HRT increases the risk of a woman’s death from breast cancer.
If you have had a hysterectomy in the past and are just taking estrogen without a progestogen, there is no change in the risk of breast cancer. There is also no increased risk of breast cancer in women who take any type of HRT when they are under the age of 51 years.
Most women will have a family history of breast cancer because it is a relatively common disease. However, it is estimated that only about 10% of the breast cancers that are diagnosed every year have a genetic or familial cause. There is no strong evidence that having a family history of breast cancer puts you at any higher risk of getting breast cancer if you take HRT, compared to women who do not have a family history of breast cancer.
Most women who have a family history of breast cancer do not go on to develop breast cancer, regardless of whether they take HRT or not.
That said, there there are different factors at play in determining an individual’s risk during HRT which is why it is so important to have a personalised consultation with a Menopause Specialist at BioConnect .
You can play an active role in lowering your risk of breast cancer following some important recommendations:
- Stay a healthy weight
- Exercise Regularly
- Don’t smoke
- Limit alcohol consumption
And remember to look at and feel your breasts regularly for anything that’s abnormal and report all changes to your doctor. It’s especially important to attend all your breast cancer screening appointments.
Blood Clot Risk
BioConnect offers estrogen HRT as a patch, gel, cream, spray or sub-dermal implant and these do not increase the risk of blood clots.
If you have read or heard that HRT causes blood clots it is because the risk was once present when taking older types of HRT orally (usually tablets). This is why it is critical that you seek out Menopause Specialists who always have the most recent and up-to-date research and information.
If you take estrogen in any form (and still have your womb) you will need to take progesterone to keep your womb lining thin and healthy. As mentioned above, older, synthetic progestins are linked with an increased risk of blood clot while bioidentical progesterone isn’t. It really is the safest way to take progesterone.
If your doctor has told you HRT is not safe because you have a risk of blood clots, this might be incorrect. There are studies showing that transdermal estrogen and bioidentical progesterone do not increase the risk of clotting even for women with lupus or other clotting disorders such as Factor V Leiden. Obviously every case is unique and your menopause specialist will address all the different factors at play in determining your individual risks.
Cardio-Vascular Disease Risk
HRT does not significantly increase the risk of cardiovascular disease (including heart disease and strokes) when started before 60 years of age and may, in fact, reduce its risk.
Taking HRT tablets is associated with a small increase in the risk of stroke, but the risk of stroke for women under age 60 is generally very low. This is why BioConnect offers estrogen HRT as a patch, gel, cream, spray or sub-dermal implant.
Women who start HRT during perimenopause or within 10 years of the menopause (the time when periods have completely stopped for one year) have a lower risk of heart disease than women who don’t take HRT.
After menopause, women’s body shape tends to change and you might see increased weight around your middle. This can lead to insulin resistance and diabetes which are linked to heart disease but HRT can help with these effects. In addition, estrogen has an anti-inflammatory response in the lining of the blood vessels and even lowers cholesterol.
Blood pressure tends to rise with age and it’s very common to have high blood pressure by the age of 60. In fact, around two thirds of adults over 60 have it.
Keeping an eye on your blood pressure and looking after your overall health can help lower your risk of heart disease. Your blood pressure is the force of your blood pushing against your blood vessel walls as it flows away from your heart and around your body. When it’s too high it puts a strain on your heart and blood vessels and this is a major cause of heart disease, stroke and many other diseases.
For most women, it’s perfectly safe to take HRT if you have high blood pressure or if you’re taking medicine to lower your blood pressure. Your doctor will simply need to keep an eye on your blood pressure and adjust your medicine if needed.
There is still some confusion around HRT and blood pressure and some women have been needlessly advised against it. However, a review of the evidence showed that postmenopausal women with normal and high blood pressure had a very low risk of a rise in blood pressure with all forms of HRT.
Estrogen taken as a tablet has the potential to raise blood pressure but taking estrogen through the skin allows your blood vessels to widen – so actually it can lower your blood pressure!
Progestogens have different effects and while some could raise blood pressure, the newer type, called bioidentical progesterone, appears to have no effect or even lowers blood pressure.
Your Menopause Specialist will also consider any other risk factors you have for heart disease before they prescribe any kind of HRT This will include your age, family history, general health, weight, if you smoke and whether you still have a womb.
Sources for further information:
National Institute for Health and Care Research