Probably none. There does not appear to be a correlation with hormone replacement therapy and ovarian cancer. Nevertheless, I always balance estrogen treatment with progesterone. There is some evidence that women estrogen dominance (overweight, infertile, polycystic ovaries and women who don't ovulate) have higher estrogen dependent cancers like breast, colon, uterine and ovarian. It's all about balance.
Breast cancer. Hormone replacement therapy has been linked to higher incidence of breast cancer, but not ovarian cancer.
No. Causes of ovarian cancer are poorly understood. In some cases, there is a hereditary risk. There is no evidence that hormone therapy affects ovarian cancer. There is evidence that use of birth control pills is protective against ovarian cancer.
Possibly slight. The risk of ovarian cancer is quite low. Some studies have shown a possible small increased risk. In most instances the risk is not considered great enough to eliminate hormone replacement therapy as a viable option for women who are in need.
On hormone replacement therapy since hysterectomy at age 31 for ovarian cancer- now 50. Do I need to end HRT for normal menopause age?
Add progesterone. Estrogen continues to be made from the fat cells and adrenal glands so you need to be on natural Progesterone forever to balance the estrogen. It stimulates the p53 gene to protect you from cancers.
Not exponentially. Data from the whi (women's health initiative) study show that estrogen alone does not significantly increase the risk of breast cancer, especially if started within 5 years of menopause. However, estrogen + Progesterone (needed when women still have a uterus to prevent uterine cancer) increases the risk of breast cancer to about 2x the baseline risk. Progesterone appears to be the "bad guy".
No. But long-term exposure is probably assocaited with a greater risk of breast cancer. But the actual risk is hard to prove and is certainly not exponential. Still, best not to take ert for more than 5 years unless you are very sympomatic from menopausal symptoms.
Absolutely Not. The whi as now reviewed was a very poor study overall and likely answers few clinical questions. I agree with the former answer that the progestin component was implicated but would not implicate Progesterone specifically. It was provera, (medroxyprogesterone) a synthetic Progesterone used in the study. The study population does not represent the typical patient we see. You need a consultation with hormone dr.
Not likely. Hormone replacement therapy remains one of the most effective means of controlling and sometimes eliminating these symptoms. Our current thinking is that for healthy women in their 50s -- women who have not had breast cancer or a history of blood clots -- and have been experiencing the symptoms of menopause for less than 10 years, hormone therapy can be very effective for symptom relief.
Short term safety. There is no apparent increased risk for short term use of hormone therapy, with or without a family history. For longer term use (greater than 4 years) it is not clear exactly how the different estrogen and Progesterone formulations and combinations affect risk.
Varies. If a first order relative (mother, sister, daughter) has bc I would take ert only briefly and then only for severe symptoms. Remember that we try to prevent breast cancer by prescribing tamoxifen - which blocks estrogen. Adding ert definitely increases risk, somewhat, so you have to balance risks/benefits. Some women are miserable without it - and a short course may be appropriate for them.
It can. The cause of breast cancer is so complex and poorly understood that it's better to talk about "associations" rather than "causes". Studies have shown that women who have used hormone replacement have a slightly higher incidence of breast cancer as compared to women that have not. In general, if you can avoid it, it's better to, especially if you have other risk factors for breast cancer.
In short, no. There are three human esrogens: Estradiol (from the ovary), estriol (from the placenta in pregnancy) and estrone (from peripheral fat conversion). Estrone is probably the culprit since women with excess peripheral body fat have increase rates of estrogen related cancers (breast, uterus, ovary, colon). Many oral estrogen hormones on the market are converted to estrone in the liver.
Increases risk. Hormone replacement therapy (hrt) has been shown to increase one's risk for breast cancer if taken for longer than 5 years. The current recommendation is to take low doses for a limited amount of time and then stop. There are some other non hormonal medications that can be used to help manage menopausal symptoms.
Depends. Virtually all of the studies showing that hrt increases breast cancer have been done on premarin (conjugated estrogens). Premarin (conjugated estrogens) is converted to estrone in the liver when taken orally. Overweight women convert adrenal hormones into estrone in peripheral body fat & have increased rates of estrogen dependent cancers (breast, colon, uterine). I suspect the culprit is estrone, not estradiol/estriol, the other human estrogens.
Hormone replacement therapy. Estrogen alone increases risk of uterine cancer. Adding progesterone increases risk of breast cancer, but reduces risk of uterine cancer. What's the right balance?
Individual. Yes, estrogen alone does increase the risk of uterine cancer over time. And yes the whi showed that the combination of a certain synthetic estrogen and a certain synthetic progestin increased the risk of breast cancer. But most specialists do not use those older types of synthetic hormones and with newer medications the risks are lower and different. So a balance can be achieved.