The Benefits And Risks Of Taking Hrt To Treat The Symptoms Of Menopause
Menopause is the natural point in a womans life when her ovaries stop producing the hormones estrogen and progesterone and her menstrual periods stop. This usually happens between the ages of 45 and 55 but can vary. A woman may reach menopause early as a side effect of medical treatment such as chemotherapy or having her ovaries removed.
Symptoms of menopause include hot flashes, mood swings and trouble sleeping, but every womans experience is different. Some women may not be bothered by symptoms, while others may find it hard to cope with them. Treatment options are available to help ease symptoms.
Hrt And Endometrial Cancer
Chronic unopposed endometrial exposure to estrogen increases the risk of endometrial hyperplasia and cancer. Progestin association is important in ensuring endometrial protection in women with an intact uterus. The previously cited study of Watchel et al. that analyzed the relationship between the HRT prescription and cancer incidence, highlights an increase in the incidence rate of endometrial carcinoma after the dramatic drop in HRT prescription consequent to WHI result publication: the 2012 rates were 1.46 times higher than those in 2001, whereas other study found only a change in trend for mortality but not in the incidence .
Treatment To Lower Androgen Levels From Other Parts Of The Body
LHRH agonists and antagonists can stop the testicles from making androgens, but cells in other parts of the body, such as the adrenal glands, and prostate cancer cells themselves, can still make male hormones, which can fuel cancer growth. Some drugs can block the formation of androgens made by these cells.
Abiraterone blocks an enzyme called CYP17, which helps stop these cells from making androgens.
Abiraterone can be used in men with advanced prostate cancer that is either:
This drug is taken as pills every day. It doesnt stop the testicles from making testosterone, so men who havent had an orchiectomy need to continue treatment with an LHRH agonist or antagonist. Because abiraterone also lowers the level of some other hormones in the body, prednisone needs to be taken during treatment as well to avoid certain side effects.
Ketoconazole , first used for treating fungal infections, also blocks production of androgens made in the adrenal glands, much like abiraterone. It’s most often used to treat men just diagnosed with advanced prostate cancer who have a lot of cancer in the body, as it offers a quick way to lower testosterone levels. It can also be tried if other forms of hormone therapy are no longer working.
Ketoconazole also can block the production of cortisol, an important steroid hormone in the body, so men treated with this drug often need to take a corticosteroid .
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Reducing Ovarian Cancer Risk While On Hrt
Certain strategies can help people minimize risk of developing health conditions while using HRT medications. Taking the lowest possible dose that still provides symptom relief can help. Additionally, when you stop using HRT as soon as possible after your menopausal symptoms disappear, you lessen your risk.
If you experience vaginal or urinary problems, but dont have other symptoms like hot flashes, it may be a good idea to use a vaginal insert form of HRT rather than systemic medications, like pills that are taken orally. This is because the vaginal insert forms usually contain lower doses of hormones than systemic options. It is also because hormones delivered systemically are usually absorbed into the bloodstream, where they can affect other organs in the body
Adopting healthy lifestyle habits may also help protect against cancer. While they dont seem to lower a persons overall risk of ovarian cancer, practicing more of these habits may be linked to a smaller likelihood of developing certain types of ovarian cancer, including serous cancer and metastatic cancer .
Healthy habits include:
- Eating a balanced diet full of nutrients
- Getting more physical activity
Two Things You Can Do Starting Today
If youre wondering what you can do today to start taking active control over your health and well-being, here are a couple of things:
Do Monthly Breast Self-Exams
The first important thing women should do is establish a monthly breast self-exam. Oftentimes, women will not do them on a routine basis, then all of a sudden they will do one and feel a lump or bump. They get concerned and worried about what this might mean.
When you do a monthly breast self-exam, you become familiar with what your breast tissue feels like. If you feel a possible lump, you may not be as concerned because youll know what does and doesnt belong, and if anything has changed.
If by chance you do feel something and youre not sure what it is, get it evaluated with an updated mammogram. In the meantime, lets all make sure that were being healthy and wise by doing a monthly breast self-exam.
Get Your Hormone Levels Checked
We believe in empowering women to own their health and happiness. If you are a breast cancer survivor or are experiencing the symptoms above, please give us a call at 513-791-9474 or fill out our online consultation form to get started on your personalized journey. We are here to help you feel better, live better, and look better.
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Cancer Treatments Including Chemotherapy And Hormone Therapy
Chemotherapy and hormone therapy are two cancer therapies that can significantly affect vaginal lubrication. These medications may disrupt the bodys normal hormonal production, reducing lubrication and making sexual activity uncomfortable, if not painful.
Vaginal dryness can also lead to a decrease in natural secretions, which might raise the risk of infection. The use of lubricants or vaginal moisturizers is one option for managing the adverse effects, which is why its crucial for cancer patients receiving these therapies to discuss their needs with their healthcare professionals.
How To Tell If Hormone Therapy Is Working
If you are taking hormone therapy for prostate cancer, you will have regular PSA tests. If hormone therapy is working, your PSA levels will stay the same or may even go down. But, if your PSA levels go up, this may be a sign that the treatment is no longer working. If this happens, your doctor will discuss treatment options with you.
If you are taking hormone therapy for breast cancer, you will have regular check-ups. Checkups usually include an exam of the neck, underarm, chest, and breast areas. You will have regular mammograms, though you probably wont need a mammogram of a reconstructed breast. Your doctor may also order otherimaging procedures or lab tests.
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Can A Person With A Family History Of Breast Cancer Take Hrt
A 2019 article in the journal Archives of Breast Cancer states that there are no guidelines on the safety of HRT use in those with a family history of breast cancer.
A systematic review from 2021 notes that HRT does not have a relevant effect on the risk of cancer in those who carry the BRCA gene.
Another study from 2018 found that the use of estrogen after surgery to remove the ovaries does not increase the chance of breast cancer in those with the BRCA1 gene. However, they also note that further research is needed on the effect of progesterone-containing HRT.
Breast Cancer Now suggests that a person should speak with a doctor before using HRT if they have inherited a breast cancer gene, such as BRCA1 or BRCA2.
Why Does Hormone Therapy Cause Side Effects
Hormones are chemicals made by the body that move through your bloodstream. They control the activity of certain cells or organs. Changes to the amount of a hormone in your body can interfere with a specific activity in the body and cause side effects. Some hormones affect several body functions, so hormone therapy can cause many different side effects.
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Estrogen And Breast Cancer
The molecular form for one type of estrogenA female sex hormone that is primarily produced by the ovaries. Its primary function is to regulate the menstrual cycle and assist in the production of secondary sex characteristics such as breasts. It may even play a role in the production of cancer cells in the breast tissue. called estriol. High levels of estrogen in the body have been shown to be a risk factorAnything that increases or decreases a persons chance of developing a disease. for breast cancer.
High estrogen levels in the body are believed to dramatically increase our risk of breast cancer. It is therefore worth understanding what estrogen is and how you can control your estrogen level at the same time as other breast cancer risk factors.
How Long Do I Take Tamoxifen
The American Society of Clinical Oncology recommends that:
- newly diagnosed premenopausal and perimenopausal women take 5 years of tamoxifen as their first hormonal therapy after this first 5 years is done, the hormonal therapy taken for the second 5 years would be determined by the womans menopausal status:
- postmenopausal women could take another 5 years of tamoxifen or switch to an aromatase inhibitor for 5 years
- pre- and perimenopausal women would take another 5 years of tamoxifen
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Additional And Sensitivity Analyses
To assess possible age related differences in risks associated with exposures to hormone, we performed additional analyses for different age categories at the index date: 50-59 years, 60-69 years, and 70-79 years. We ran another subgroup analysis for women in three different BMI groups: less than 25, 25 up to 30, and 30 or more. In this analysis, we included only controls in the same body mass category as their matched case.
For the main analysis, we considered women to have recently used HRT if they had a prescription between one and five years before the index date. The risk associated with HRT has been found to decrease rapidly after discontinuation,20 so we needed a measure showing excess of risk for the most recently exposed women. To assess this, we repeated the analysis, defining recent use as exposure between one and two years before the index date.
The main analysis was run on women aged 50 to 79, which may include some premenopausal and perimenopausal women who have a higher risk of breast cancer.21 To deal with this and provide comparability of our results with those of a meta-analysis,11 we also ran an additional analysis restricting our sample to women aged 55 to 79.
We used Stata v16 for all analyses. A 1% level of statistical significance was used to allow for multiple comparisons. To facilitate comparison with other studies, however, we present the results as odds ratios with 95% confidence intervals.
Use Of Hormone Replacement Therapy And Risk Of Breast Cancer: Nested Case
- Accepted 17 September 2020
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Do You Need To Count Calories
Many people believe that if you eat fewer calories than you burn each day, youll lose weight, and if you eat the same number of calories that youll burn, youll maintain a healthy weight. This plan works for many people, but not all.
If youre counting calories, its important to think about what youre eating. Say Jane eats 1,200 calories a day of cake, cookies and white bread. Shes probably not going to lose any weight. Betty eats 1,200 calories a day of fresh vegetables and fruit and lean protein. Shes probably going to lose some weight and get a lot more nutrients from her food. Counting calories is only part of the weight loss equation.
And counting calories is only one way to lose weight. Because the hormone insulin plays a major role in how your body uses and stores fat, some research suggests that eating foods that keep insulin levels steady throughout the day lean meat and fish, poultry, vegetables, and fruit rather than foods like sugar, candy, white bread, and crackers can help you maintain a healthy weight.
The first thing to do if you want to lose weight is to talk to your doctors and a registered dietitian about a safe and sensible plan designed specifically for you and your needs. Your doctors may want you to wait until you have completely recovered from treatment or any other health issues you may have.
These steps can help you lose weight after treatment:
Vasomotor Symptoms Hot Flashes
The so-called hot flashes or, more precisely, vasomotor flushings are a common and well-described treatment toxicity in men undergoing androgen ablation and are one of the most frequently reported adverse consequences of ADT. Spetz et al performed a prospective analysis comparing the incidence of hot flashes in men receiving CAB to that in men receiving estrogen therapy for treatment of PC.52 In this study, in 915 patients with metastatic disease, 458 were treated with polyestradiol phosphate and 457 patients received CAB. Of men receiving CAB, 74.3% reported hot flashes compared to 30.1% in men receiving estrogen therapy . Further, a significantly greater percentage of men treated with CAB were greatly distressed by the hot flashes and reported at least 4 hot flashes per day . ADT-associated vasomotor flushing remains a common complaint reported by men receiving this therapy and is reported in up to 80% of men receiving ADT. Interestingly, megestrol acetate has been demonstrated to reduce hot flash symptoms by up to 85%. On the other hand, chills, weight gain, and carpal tunnel-like pain are the reported side effects of megestrol acetate.53
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Role Of Hormones In Endometrial Cancer
The established risk factors for endometrial cancer show that exposure to estrogens unopposed to progestins can predict risk of endometrial cancer . During the pre-menopausal period, risk of endometrial cancer can be attributed to mitotic activity during the first half of the menstrual cycle when estrogen is unopposed by progesterone . Use of sequential oral contraceptives doubled the risk of endometrial cancer among women who used them prior to their removal from the market in 1976 . In contrast, combination oral contraceptives , which deliver estrogen and a high dose progesterone for 21 days of a 28 day cycle, decrease the risk of endometrial cancer .
Obesity is also an important risk factor for endometrial cancer. In post-menopausal women, it is postulated that the conversion of androstenedione to estrone in adipose tissue results in the increased risk. In premenopausal women, obesity is thought to operate through increased anovulatory cycles and associated progesterone insufficiency .
The protective effect of parity can also be explained by the unopposed estrogen hypothesis . The highest risk of endometrial cancer occurs in nulliparous women and risk decreases with each pregnancy. This is explained by the fact that no mitotic activity occurs during pregnancy due to the persistently high progesterone levels.
Hrt And Ovarian Cancer
Histologically, surface epithelialstromal tumours are the most common neoplasms of the ovary. They derive from the ovarian surface epithelium or its derivatives and occur in women of reproductive age and beyond. They are histologically composed of one or more distinctive type of epithelium, admixed with a variable amount of stroma. Their biological behaviour varies with histological type.
Because 5060% of non-mucinous ovarian carcinomas have estrogen receptors , a relationship between HRT and occurrence of ovarian carcinoma is possible in principle . A recent review of 20 pertinent studies reached no satisfactory conclusion, as all studies differed in size, outcome and exposure, so that no reliable comparison is possible. Five studies described a slightly increased risk associated with HRT , whereas 15 did not. As in the case of endometrial carcinoma, the question is again whether these findings are due to induction or to a previously undiscovered ovarian carcinoma which becomes apparent under therapy. Currently no increased risk of ovarian cancer associated with HRT use can be assumed, because the evidence is inconclusive.
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What Are The Benefits Of Bioidentical Hormone Replacement Therapy
The benefits of bioidentical hormone replacement therapy are many and include:
- Encouraging bone growth and protecting bones from osteoporosis
- Eliminating or reducing hot flashes
- Reducing night sweats and insomnia
- Increasing energy and reducing depression
- Improving memory and concentration
- Enhancing sex drive and libido
- Accelerating fat burn
What Is The Link Between Estrogen And Uterine Cancer
Uterine, or endometrial, cancer forms in the lining of your uterus. Women are more likely to develop this cancer after menopause.
Your estrogen-related risk may go up with:
- Estrogen replacement therapy: Estrogen eases menopausal symptoms like hot flashes, night sweats and vaginal dryness. But taking estrogen alone increases the risk of uterine cancer. Combination hormone therapy is less likely to cause uterine cancer. If youve had a hysterectomy, you dont have a uterus and cant get uterine cancer.
- Tamoxifen: Tamoxifen is a breast cancer drug that lowers the risk of breast cancer and breast cancer recurrence. Its a selective estrogen receptor modulator that blocks estrogens effects on breast tissue. But in menopausal women, tamoxifen acts like estrogen in your uterus. It stimulates the growth of your uterine lining, increasing endometrial cancer risk. Still, the chances of developing endometrial cancer from tamoxifen are less than 1% per year. Theres also a slightly higher risk of uterine sarcoma, a cancer that forms in uterine muscles or tissues.
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