26 Apr 2018

Words of comfort about HRT and Breast Cancer

Professor Baum on HRT and breast cancer...

I spent most of my professional career researching and treating women with breast cancer.

Apart from the existential threat of the disease, these poor women had to suffer the impact of treatment on their quality of life (QOL).

The consequences of mastectomy on QOL are largely a thing of the past, however, the consequences of chemotherapy persist.

We recognise the threat of alopecia, nausea and vomiting during the 6 months they must endure cytotoxic chemotherapy, but we lose sight of the problems of menopausal symptoms that may persist for the remaining years of their life.

These symptoms can also be precipitated amongst women who were on HRT at the time of diagnosis and were forced to come off the drugs by their clinicians.

Furthermore, long-term hormone therapy is often associated with hot flushes and pains in the joints.

Because of my outspoken views that the evidence of the harms of HRT were over-inflated, I was seen as a “soft touch”, and my clinics often had patients coming for a second opinion.

This way, I learnt just how much women suffered because their treating physicians threatened them with the risk of premature death if they continued their search for a tolerable quality of life.

It’s about time doctors got up to date about the benefits of HRT that in my opinion, far outweigh the harms.

HRT stands for hormone replacement therapy involves a combination of oestrogen and progesterone. (The latter to protect the lining of the women from endometrial cancer.)

Women who have had a hysterectomy are treated with oestrogen replacement therapy (ERT).

100 years ago, the expectation of life for women was about 50; today it’s approaching 80.

The problem of the menopause syndrome is, therefore, relatively new.

The symptoms of the menopause are much more than hot flushes and night sweats but also include:

Insomnia, concentration, memory loss, energy loss, urinary infections, vaginal dryness, decrease in libido, depression, anxiety, mood swings, bloating, aching joints, thinning hair and weight gain!

Most of these symptoms can be controlled or at least improved by HRT(ERT).

If a woman has thyroid deficiency, she might experience many of these symptoms, yet she would be cured by being prescribed thyroxine, so why is there a stigma about prescribing oestrogens for ovarian deficiency?

My default position is, therefore, to offer women HRT for these problems and let anyone challenge me about the hypothetical risks.

Oestrogens do not increase the risk of breast cancer. In fact, ERT reduces the risk of breast cancer.

Amongst the most common causes of death for women are heart attacks, strokes, dementia and osteoporosis. All of which can be reduced by HRT. Oestrogen replacement therapy, therefore, can improve the length of life as well as QOL.

Ladies of the “Latte Lounge”, if your gynaecologist tries to frighten you off then change your gynaecologist.

I have no conflict of interest, I am not in the pay of Big Pharma; I just care for the welfare of women.

There's more to life than a constant fear of breast cancer, which now only accounts for 3.7% of deaths in the UK and falling, whilst 32% of women will die from dementia, heart attacks or strokes, all of which can be improved by treating “Ovarian deficiency” disease.

Ref: Estrogen Matters: Why Taking Hormones in Menopause Improves Women's Well-Being, Lengthens Their Lives—and Doesn't Raise the Risk of Breast Cancer.

Are you considering if HRT in the UK is the right choice for you? With numerous treatment options available for the perimenopause and menopause, it can be overwhelming to know where to start.

Read our guide on Hormone Replacement Therapy (HRT), a treatment that can help to alleviate menopause symptoms and improve your overall quality of life.

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