Friday, December 15, 2006
Less HRT may be the key to less breast cancer
It is nice to blog about some good news every once in a while. A new study shows that breast cancer rates plunged 7 percent overall and in some cases as much as 14 percent in 2003. That is especially good news considering there had been a steady increase in breast cancer from 1975 to 2000, with almost a 30 percent increase over that time. (Full Story)

Most interesting perhaps, is that many researchers believe they know exactly why the rate is going down.

They point to the swirling negative problems surrounding hormone replacement therapy or HRT. In July 2002, the Women's Health Initiative warned that HRT could actually lead to an increase in breast cancer and heart disease. It seems patients and their doctors started to pay attention. By the end of 2003, the number of prescriptions written for HRT went from around 22 million to 12 million. Shortly thereafter, we started to see the first declines in breast cancer. At first, it was just small changes but now for women with estrogen-fueled tumors, the most common breast cancer rates have dropped up to 14 percent. For all age groups, the rate dropped 7 percent.

Not surprisingly, representatives from the American Cancer Society are being cautious. After all, it is just one year's worth of data and that hardly makes a trend. Still, that hasn't dampened the enthusiasm of breast cancer researchers who have been working their entire lives for a win.

What is most difficult, though, are the conversations I have had with many women around the country about HRT. So many of these women are simply debilitated and unable to function because of the frustrating symptoms of menopause. They will read today's news and still refuse to give up their HRT, even though they know it could dramatically reduce their risk of breast cancer. To them, the risk is worth it. So, what should doctors tell these women and is there anything else out there that works?
Maybe I am biased because I'm young, but after witnessing my mother go through menopause, I didn't see anything about it that couldn't be satisfactorily treated with a healthy diet and regular exercise. Hormone Replacement Therapy seems like such an incredibly risky gamble if you are faced with life that could lead to breast cancer, or life that leads to health and happiness. Am I totally off base on this?
I do not think that anyone who has not yet gone through the menopause should be making comments like "healthy diet and plenty of exercise" - absolute rubbish! I am 50 and a vegetarian with an extremely healthy diet and take more than the recommended daily exercise. However this has had no effect on the menopause symptoms. So after several months of hot flushes and problems in sleeping I went on to HRT. Within 5 days I felt like a new woman. It really is worth it. (my friends who have also had a difficult menopause feel the same way - they feel human again).
My question is if HRT causes breast cancer what about the pill in younger women. Can it really be safe to take the pill for years and years it it's unsafe to take HRT?
I have watched my aunt and stepmother go through menopause without HRT successfully. Yes, the hotflasshes and moodiness persist but these can be handled through diet, exercise, and vitamin supplements. One question, my GYN told me birth control equates to HRT as well, since it uses progesterone to "mimic" pregnancy. Are BCP hormones lumped in with HRT in the cancer risk?
This also supports the idea that women who take hormone shots for in vitro fertilization (IVF) are elevating their risks for breast cancer, as are women who have children when they are older, since that increases their lifetime exposure to estrogen. Doctors and the media should be more aggressive about letting these women know they are at higher risk, and therefore need to be sure to get mammograms every year...
I am confused - doesn't the contraceptive pill have estrogen in it? How come it is safe to take it in that form, but not around menopause in the form of HRT? If Breast cancer has been steadily on the rise since 1975, couldn't that show a link to the contraceptive pill - which, after all, really came into it's own in the late sixties, early seventies?
I am one of those women who has debilitating multiple hot flashes every hour as well as waking up all night long with night sweats. Not even daily exercise, diet, or alternative homeopathic remedies help. Therefore, even though I have a history of breast cancer in my family, I will continue to take the smallest dose of HRT which effectively lets me live my life without these debilitating symptoms. I am constantly talking to my doctors about the latest research for new remedies, but haven�t yet found one who can give me alternative answers. I will continue to do research on my own and will monitor my health with monthly self-breast examinations and yearly mammograms. Each woman has to make the best choice for her own situation.
I am a post menopausal 35 year old and I could not function without HRT. I can only hope to get through these symptoms quickly and get off HRT. Does it worry me? Heck yes. Can I deal with the hot flashes and constant weeping? Heck no.
I work out with a trainer 2x week, yoga 1x week and take deep water cardio classes 3x week. My diet consists of lean, hormone free protein, vegetables and 70oz of water per day. I am doing everything possible to control these symptoms. The only thing that works is the HRT.
This is wonderful news, but women need to have more facts regarding Biodentical hormones as well. Were they part of this testing?
I am currently experiencing menopause. I agree that proper diet and good exercise are key. Getting enough sleep is also important. I practice martial arts which engage the body, mind and spirit. Menopause is just another normal part of our lifecycle which we can accept and deal with. It's natural.
I have been on HRT since 2000 with the exception of the year after the report came out about the negative findings related to HRT. That year was unquestionably the worst for me and nothing, diet, exercise, vitamins, holistic, naturapathic, nothing abated the symptoms. Further, I could not tolerate any of the bone replacement therapies so I was at risk for osteoporosis. I went back on HRT and two years later, my bone scan looks good and I feel fantastic. I am willing to take the risk.
If estrogen contributes to breast cancer what about the contraceptive pills? I am quite possitive that it has the very same effect than HRT. It would be good to have more information on such an important issue.
I think it depends on the individual. It's great that some can go through menopause and not have to rely on hormones. But it's impossible for others. My mother always kept a healthy diet and exercise regimen, but she had a hysterectomy at 47 and needed the hormone therapy to simply feel at balance. I understand being cautious about hormones, but if you protect yourself to the point where you can't enjoy the life that you have now, then what's the point?
There is a huge difference between artificial hormones and natural hormone replacement therapy. All the testing that has been done was for Artificial hormones which can cause cancer. There is not enough data to help women make informed decisions. Having started pre-menopause at an early age--I doubt I could have servived the depression without HRT. There needs to be more information on natural hormones so women can make better life choices.
I have never taken a hormone in my life, have been thin all my life, and have done everything I could to avoid getting breast cancer. I was diagnosed with breast cancer last year at the age o 54-go figure!
I still think short term use of HRT is okay - it's long term use that really causes breast cancer. Any woman with menopause symptoms can use HRT for a year or so to get over the worst, but then its best to taper off. I know that the HRT drug companies put out lots of stuff - to doctors as well as patients - making it lok like you could stay young forever with HRT. WHI proved that wasn't true, and this sort of study proves that the risks of using HRT long term are just too great to simply manage hot flushes and crankiness.
I am a women in my fifties who has been taking a low-dose HRT for the past two years. I am one of those women who is afraid to stop taking it because I don't want menopausal symptoms to return and none of the natural remedies I tried prior to HRT work. Of course, I do not want to be a breast cancer statistic as you implied, but I don't want to suffer with hot flashes every day either. I often feel as though medicine and science tend to neglect the needs of female related diseases and problems until it reaches epidemic proportions or become newsworthy. Why can't something be done to ease the suffering we have to face daily because we are women?
I spent a year tapering off hormone replacement therapy and then quit. Within two weeks, the incredibly uncomfortable hot flashes returned. Today I take .3mg of estrogen every three days and it keeps the hot flashes at bay. My doctor said that small amount wouldn't help me, but it does. Hopefully it won't significantly increase my risk of breast cancer.
In 1992 I had breast cancer when I was 33 and have been clean since. When I reached menopause my doctor put me on Evista and 'knock on wood' I still haven't had a reocurrance. I believe the research because it has worked for me not to be on hormones. I will advise my daughter to do the same.
Doctors are telling patients the test results widely publshed about HRT are inconclusive.
I also took birth control pills for many years. I would like to hear Dr. Gupta's answer on questions that have previously been posted concerning these, and the comparison with HTRs.
I am a 41 year old breast cancer survivor who was on invitro fertilization just prior to my diagnosis. I was estrogen and progesterone positive. I had a lumpectomy with oopherectomy, chemo and radiation.I rapidly went into menopause after my oopherectomy. I have some advise for the ladies unsure of what to do with their menopause symptoms. If you think the menopause is bad, try chemo. Please, try and stick it out. There are many ways to try and feel better and for the most part, it is a temporary situation. If you do decide on HRT, do not forget your regular mammogram.
I have a horrible family history and right now I have a sister who is fighting for her life from breast cancer. I have tried to go off hormones, but I didn't even feel human. Headaches, lack of sleep and mood swings where taking a horrrible toll on me. I am taking my chances, since I have had a complete hysterectomy at a very young age for severe endrmetreosis. I am on the lowest dose of hormones and I am dilegently checking my breast and have a yearly mammogram. What is the right answer, I really don't know, but I do know that I want to be able to function.
Dr. Gupta,

I am reading with much interest in your blog of women complaining about the debilitating symptoms of menopause.
I keep on trying to tell my family and doctor how I feel-- grossly tired, run down, unable to wake up feeling good, etc.

They all either say " stop complaining and go to work" or ignore it. "Be a big girl, or stop sittin' around on your ass, mom" they say.

Seems to me some of us still live alone with this...

Patricia Dumas
The Jersey Shore
I've always maintained proper exercise and diet, have been very healthy, and thought others' stories about menopause were simply whining, and was certain I'd be immune to symptoms. I became menopausal at age 48 and attempted to tolerate the symptoms, but after months of sleepless nights and hot flashes I made the decision to accept the risks of HRT. I've been on bioidentical hormones for 18 months, with great improvement, but find I have to continually have them adjusted. I'm planning on obtaining a consultation for pellet implantation of estrogen, which supposedly provides improved regulation of hormone release and bypasses the liver. I have annual mammograms and female exams, but to me the risk is worth the improved quality of life, and my husband deserves it too. Unfortunately, the mainstream medical community is adverse to the treatment, which makes it even more difficult and costly for women like me who choose HRT.
I am a 17 year survivor of breast cancer, was diagnosed in my early 40's, was on taxifomen for 5 years which put me through the change at an early time in my life. Although I did have some problems related to early menopause I did not take any HRT, the risk wasn't worth it to me. In my opinion was better to deal with the promlems related to menopause than take a chance on reoccurence of my cancer.
Dr. Gupta my gynaecologist prescribed HRT for me. I took the hormones three times and suffered a heart attack. When I told my story to the doctors and nurses who treated me at the hospital, they all told me that it wasn't possible and that it was just a coincidence. However I was fortunate that my heart wasn't damaged but I am still taking medication to this day.
There is no one-size fits all solution as the severity of menopause symptoms vary significantly from one person to the next. I stopped HRT in 2002 but still experience about 10 hot flashes a day. Exercise and diet don't seem to have any effect on symptoms. If you are one of those with mild symptoms, count your blessings; but unless you've experienced the severe symptoms visited on some of us you have no idea how dibilitating the lack of sleep and hot flashes can be.
If there is a connection between HRT and breast cancer, isn't it probable that there is also one between birth control pills and breast cancer? How else do you explain the dramatic rise in breast cancer in baby boomer women who, not coincidentally, are the first generation to take the pill? I know that there has been research over the years that says there isn't a link, but I'm not so sure anymore. I took the pill for nine years in the late 70's and most of the 80's when it had higher hormone dosages, and sometimes I worry if it is a decision I will regret. The pill was supposed to liberate women, but that liberation may prove to have come at a very high price. I guess all I can do is get annual mammograms and hope for the best.
Intersting point made at the end of Dr. Gupta's blog in acknowledging that even in the face of evidence that the drop in HRT has correlated with an incredible drop in the number of women diagnosed with breast cancer, some women just will not listen out of the daily convenience to take the hormonal therapy to feel 100% better. Since doctors cannot say to a patient that had been on HRT that the treatment 'caused' the cancer, some women will still continue to put their lives at risk who later develop cancer that is fed on hormones. I am a graduate student working on breast cancer research and it certainly is the greatest joy in dedicating our lives to improving our knowledge of all aspects related to oncology in order to better diagnose and treat patients. Equally, if not most importantly perhaps, is fully understanding what causes the cancerous lessions (aside from the genetic ones that we cannot control) so that PREVENTION can be in practice. Preventing cancer onset by our lifestyle choices would have a global impact especially to the communities with a lack of medical assistance. Thanks for covering such an important issue.
I went through menopause at 38 so have been on HRT for 19 years. I have tried three times to get off HRT. This time I tried going "cold turkey" for a month. My bones ached, I have worse memory loss, I am sleep deprived and just generally feel unwell. So after a month of no HRT I went back on half strength to my normal dose and that ishelping. I am still getting hot flashes but not as bad. I am also taking Vitamin E and Evening Primrose but they say these remedies can take up to six months to kick in. I would like to get off HRT totally so I will do it gradually but one has to think of quality of life also. It is a huge thing when you are feeling lousy and amazing how HRT changes all that.
We insist on scientific evidence before we will support alternative treatments, and yet we immediately debunk HRT because some scientist postulate that maybe HRT was the culprit. Where is the scientific evidence that shows HRT is the cause of breast cancer? Please don't test one HRT and say "that's it." The scientific community needs to do more extensive research on HRT and the aging female.
Well, I'm 53 and just through menopause. I'm taking 200 mg of soy isoflavenes per day and that has eliminated my hot flashes. I don't know if it would work for everybody, but it's certainly helped me! My doctor is okay with it; she didn't want to give HRT and I haven't needed it.
I am 52 and still in peri-menopause. The single biggest help for me is accupunture and Chinese herbs. I also use western herbs sometimes, in a formula specifically for menopause. Additionally, fish oil caps make a difference. For sleep I take a Benadryl - chronic allergic rhinitis contributes to wakefulness from post-nasal drip, and my legs get jumpy at night. Benadryl eliminates both problems as well as causing drowsiness.

My mother describes a decade of hell preceeding and during menopause. Our lifestyles couldn't have been more different. But I work in a natural food store and have seen women with the same healthy habits as mine who have suffered miserably during menopause. It is too easy to pass judgement about lifestyle.

The problem was doctors pushing HRT on women who didn't need it and keeping them on it for years or decades, in the belief that it would improve their overall help, which had never been proved. The big study showed the opposite and should have come as a wake-up call to everyone who is taking drugs without long term study, on the basis of medical belief in their efficacy. (Statins come to mind.)

My mother-in-law had uterine cancer at age 87 - a real treat having a complete hysterectomy at that age - after over 40 years of HRT, which she took because the doctor said so (she is of the generation of people who rarely question doctors). No MD ever questioned the Rx until the day they diagnosed the cancer! Thanks alot.

We should only take drugs based on need and proof of long term safety. That would reduce many of the prescriptions being written nowadays and address some of our national health bill.
I am so happy to finally see this published. I am only waiting for younger women to find out that the birth control they are using is also increasing their risk. Next on the list would be our hormone filled dairy products and meat. I believe breast cancer is for the most part preventable, but we need to inform people.
Unlike many people, I do not think menopause is a "disease" that needs to be treated. I am 64 years old, and I refused to take hormones. I even switched doctors since my doctor was so gung-ho about getting me on horse-derived hormone pills. I am so grateful I declined.
I am 35 and had a total hysterectomy two years ago. Since then I have used the Ortho-Evra patch for HRT with very good results. Because of my particular case it has been recommended that I be on HRT for many years. I would like to know how cases like mine fall into these studies. There is never any mention of such cases and the effects of HRT on women with such long-term use. Any what are our alternatives?
My wife is at the tail end of Kemo and radiation treatment for breast cancer. She never took HRT. No one has been able to tell us why she got the cancer in the first place. Can you.
If estrogen-fed tumours are the problem, the contraceptive pill must be a factor in their growth. Since this is the case, women need to abandon the pill right away. Isn't that obvious?
I began the menopause process 12 years ago. I had all the classic symptoms and was, now and then, borderline miserable. I was wary of HRT, however, because of problems I'd had with the pill years before. My female doctor essentially "fired" me because I refused to use HRT and I was, in her opinion, too uncooperative. What helped me most was being informed. I studied and then found that exercise, vitamins and laying off the spicy foods relieved my symptoms considerably and just made me feel better, in general. I'm so glad I stayed my course and think everyone should basically do what she feels is best for her, despite the negatives.
I agree with Jennifer from Buffalo. I am a younger woman as well but I exercise, eat right and get enough sleep even though I have two small children. I have no PMS (which I think is a load of you know what), had very easy deliveries and stay away from trans fats and very processed foods. I am not a full time vegan or vegetarian but I believe there is a strong link to how we as a society feel when we eat pesticides, extremely processed foods etc. Do you know what Disodium Phosphate and Disodium Inosinate are? Well I don't either but if you eat Doritos they're in there and a lot of other foods. Go to Whole Foods and find healthier versions of the foods you love (including Doritos). Let me be clear, I'm not saying that everyone in the world is exaggerating about their symptoms but I really do believe that in this country we are so overmedicated and hypnotized by the drug companies that we don't try enough to feel better on our own.
Diane Schulz CPT
What age group was used in the WHI 2002 study? In the controlled group that used estrogen alone, the rate of increased breast cancer was actually insignificant. I think the media, again, is misinforming women about HRT.
Yea!!!! It is about time that we stumbled into some answers. There doesn't seem to be much progress in locating reasons for Breast Cancer. Makes me wonder if men had as much BC if there would be much more progress. Hmmmm
My mom, who's in her mid 70s, has always been strong, active and healthy; furthermore, she's always been one to "tough it out" rather than take medication. However, since she's had to stop HRT because of breast cancer risk, she says her quality of life has decreased so much that she'd much rather risk the cancer.
I haven't yet gone through it, so I don't know for sure. But like with everything else, a diet low in both sugar and fat (NOT just one or the other), and high in fiber, along with DAILY exercise and plenty of rest, has got to make a difference for most women. In addition, soy, which is a plant estrogen, may be a helpful thing to add to the daily diet. I have also read about the positive effects of Black Cohosh for women with hot flashes and other menopausal symptoms. The reality is, there is ALWAYS more than one solution to every problem, if there is any solution at all. Don't ever buy the bull that there is only one solution to a problem. The person who says this is simply too lazy to look for another solution. It is this very kind of thinking that got us into the current bloody war from which we now cannot find a graceful exit.

I also agree with posters who say there needs to be more pursuit of honesty in breast cancer research. It is illogical not to suspect that birth control pills, which have a MUCH HIGHER concentration of estrogen, are also contributing to skyrocketing breast cancer rates over the past 30 years. Once again, it seems that researchers have put their blinders on in the interest of being political correct.
Low levels of estrogen in post-menopausal women can lead to genital atrophy as well as lowering the risk of breast cancer. What kind of a choice is this?
I am 53 and finally post-menopausal. Every woman experiences menopause differently. Diet, exercise and supplements may be sufficient for some but for many they are not. I have almost every risk factor for osteoporosis and none for heart disease. I am seriously contemplating very low dose HRT because of its proven track record for increasing bone density (and don't tell me to use only diet, exericse and supplements to prevent osteoporosis--I already do that and it is not enough.) The link to breast cancer is very scary so I must weigh the "odds"--the possibly slight chance of getting breast cancer with HRT, or almost certainly suffering from osteoporosis without it.
When my menopause symptoms got to the point where I was having anxiety attacks with each hot flash and depression was creeping in, I went on HRT. Soon felt like my old self! Had great doctor's advice to wean myself off it after one year to see if it was still needed. I still have hot flashes at night, but totally do-able. The scarey news is that I just had an abnormal mammogram. I have to go for more films and a possible biopsy. I'm praying it's nothing...but if it is cancer...possible link to my HRT? I am considered post-menopausal now, and the rate of breast cancer at this point really goes up. In hindsight, I would have tried more natural remedies.
I'm 52, had a total hysterectomy 11 years ago and was on HRT until early this year when I developed a lump in one breast. It turned out to be pre-cancer, so am off the HRT and on Evista which has been found to aid in the prevention of breast cancer. I thought I would be unable to function without HRT, but experienced a brief period of mood swings, no hot flashes. I workout several times a week and try to eat healthy foods, and am fine now that my body has adjusted. I don't know what others have experienced, but for me, I want the lowest risk of cancer. I'll deal with the other problems.
I've been trying to avoid HRT for the last few months, and have found some relief with Remifemin (black cohosh),
and Chinese herbs. They're not an overnight fix, however, and took several weeks for symptoms to subside. If you can be patient, they're quite helpful (speaking from someone who could write a book about the misery of menopause!)It was a trial & error process, but I'm sleeping and feeling better.
I think it would be nice if instead of trying to recreate the wheel, research would be done on natural cures that may already be available. For example, there is a root in Mexico that helps regulate hormones. Could it be that it might not be as profitable as HRT?
Taking HRT to combat symptoms of menopause is a personal decision to be made by women along with advise from their physicians. Unfortunately, millions of women made the decision to take HRT without having accurate information about the risks and in fact they were told it was safe when it wasn't. A huge disservice has been done to women - widespread use of HRT was encouraged before the medical community really understood the risks. A 30% increase in any disease rate is outrageous.
It is interesting that when we see a dramatic increase in breast cancer (30% increase between 1975-2000) we also see a dramatic increase in abortions due to the leagalization of abortion in 1973. Many studies have proven the link between breast cancer and abortion (that the risk for breast cancer increases greatly when a woman has an abortion, and increases even more with each subsequent abortion). The increase is especially noteworthy in light the percentages of pregnancies ending in abortion (1/4--1/3 end that way). It would be worthwhile to compare current abortion trends with current breast cancer statistics.
I use Bio-Identical hormone repacement. It is a rice grain size implant enbedded into my hip every six months to a year. It is called SOTTO PELLE. Does this have the same effect on the heart as regular HRT?
I am 64 years old, took HRT for many years, and had breast cancer. For some of us, menopause is not "normal" and no amount of diet, exercise, herbs, etc., makes a dent in the debilitating hot flashes, night sweats, lack of sleep, and for some, mood swings. I tried to get off of HRT several times, managed to reduce the dose and only succeeded in quitting after I was diagnosed with breast cancer. I think it is realistic to take HRT at a lower dose and for a shorter time period, but the herbal remedies etc. don't come close to touching the problems that some of us have. Thankfully, 16 years after the start of menopause, I only have an occasional "warm" moment.
Why has the medical community failed to come up with a test that women can use for daily monitoring of hormone levels and adjust HRT dosage accordingly. Why is mandatory genetic testing not done on every women to determine if she has genetic markers for estrogen fueled breast cancer prior to any HRT prescription? Why are we not looking at other factors in the environment that may cause breast cancer? Finally, the "one size fit all" mentality should end. I believe there are women who will never need HRT replacement and women who will need it for perhaps a lifetime after menopause to function well. With better measures of hormone levels, testing of genetic markers and then, appropriate, customized dosage, women will be better served by the medical community!
Ever hear of bioidentical hormone replacement therapy?
Doctors should tell their patients that moodiness and hot flashes, no matter how extreme, are nothing compared to the side effects of chemotherapy and radiation. In addition, they do not kill you. No one knows all of the circumstances that can cause breast cancer, but the increased risk involving HRT is known. I watched my mother battle breast cancer for 15 years before she lost her life at 56 years old. I would do anything to reduce the risk of developing this deadly and painful disease, not only for myself but for my daughter.
I take estrogen..
I will continue to take it.. Even with this new "encouraging" study, I still think the risks of not having estrogen for our bodies outweigh the cancer risk..
We live longer and what is the use of living longer if we feel lousy? Are breaking bones, or we are stooped over and in pain? Have heart and health problems that prevent us from enjoying life.?
Mental confusion and frustration.
The only help for these health problems are other medications..
What are the health risks from them?
Some women do well after menapause there is no dought, many others do not..
What about birth control pills, estrogens and chemicals in food? I agree..How come we never hear about the effects of those on breast health..Or the risks for cancer later..
Are they effecting the study?
The study is just another of many and how many times have we been told somthing was bad and it turned out that it was Not...
On the other hand I do know how I feel without estrogen, I do know about the health risks of not having it too..
All these studies do is confuse and upset women..
It seems there is no perfect solution..Yet!
Or answers...
For the people--women included who believe that pre-menopausal women take HRT because we want to "feel better" do not have a working knowledge of what happens to a woman's body. It's not simply wanting to feel better--it's a matter of being able to function in our daily lives. Without HRT my mood swings were so awful I wanted to die. So if I have a choice between MAYBE getting breast cancer or living a normal live---I'll take my chances with HRT.
I too am one of those women whose menopause delilitates me totaly. I am a personal trainer and get plenty of exercise and have a very well developed diet. This makes no changes in the hormonally based effects that some women suffer from. Myself included. I do however beleive that dosages prior to these studies may have been too high. I take a miniscule amount and find that I am now able to handle the effects, both mentally and physically that menopause has blasted me with. Moodyness isnt the only mental symptom that comes with menopause, there is the anger, the depression, and sometimes the inability to control your thoughts and reactions. I know I experience all of them and have NO backround of mental instability in either myself or my family. So unless you have experienced what other women have experienced you can not say that all symptoms are handled by exercise and diet.
Three years ago I had a radical hysterectomy and immediately went into surgical menopause. I too had followed a proper diet, exercise and high quality vitamins and still developed cervical cancer within 6 months of my divorce.(stress yeah, I know, and HPV) If you think regular menopause is rough, try all the symptoms upon you at once. I literally went nuts and was ready to commit myself to a 30 day 24/7 mental facility, when I discovered I had the top ten symptoms of an estrogen deficiency. My doctor took me off the NHRT I had been on, gave me a shot of testosterone and immediately started me on 1 mg of an estrogen patch. Within 3-4 days I could tell the difference and within 7-10 days I was back. It was still a long, hard recovery but the HRT saved my life. I am not real keen on taking HRT but right now, until they come up with a better alternative, I can't live without it.
I was diagnosed with stage I breast cancer at age 40--no family history or other risk factors. I feel strongly that birth control pills are a risk factor because many women in their 30's and 40's are developing breast cancer, most of whom took birth control bills.
Hmm. Being given shots once a month plus being on Tamoxifen daily has put me into menopause. Night sweats and hot flashes -so what, I'd rather not get breast cancer again. Atrophic vaginitis - so what, I use Replens and Astroglide. Crankiness - no way, seems without all that estrogen I'm calmer and clear-headed.
For the cause to preceed the effect cancer initiation, growth & diagnosis would have to occur in one year or less? (July 2002 to decline noted in 2003)Isn't that counter to most thinking on tumor development?
Could the effect simply be on tumor growth? This would lead one to the depressing thought that there are just as many cancers out there, they just haven't grown large enough to be detected.
I was on HRT for more than ten years after my uterus and one ovary was removed. I stopped taking HRT once i changed my diet to vegetarian and have never looked back and that was six years ago. I am now 57 and still feel a flash every now and then but I have no regrets. My general health has improved since changing my diet.
I agree with an above comment that menopause is natural, and I would point out that for thousands of years women delt with it without HRT. I am young, so maybe I shouldn't speak on a subject I have not personally experienced, but I have watched all of the women in my family; grandmothers, mother, aunts, go through it without HRT. None of them believed it was a healthy thing to do - even before all of the research proving it. It may not have always been pleasant, but they did it. We need to stop relying on drugs to fix all of our problems, and I'm not just talking about HRT. Modern medicine is great, but just know that there is never a "magic pill" that has no consequences.
Have read with interest all the comments and would like to comment on the response from posted by San Antonia, TX at 12:48 pm ET. I too had severe endrometreosis at a young age and had a total hysterectomy in my early 40's. As I immediately went into surgical menopause I was put on HRT. I too chose to continue taking a low dose as the hot flashes were unbearable and as many, decided to take my chances. Imagine my surprise when I was diagnosed with Ovarian Cancer a year ago. Apparently some Ovarian tissue was left behind from the endometreosis surgery. It appears no one is "safe".
I'm a two-time breast cancer survivor at age 44. I've had a mastectomy and reconstruction, chemo (twice) and radiation. Give up your HRT!!! It's not worth it.
What about HRT creams?? Nothing is ever mentioned about it?
As a woman who is in the middle of menopause, without HRT, it can be done! Herbs have helped the hot flashes - not completely, but they are managable, and walking more has helped me sleep. The pill is as unsafe as HRT as it contains not only estrogen, but DES or diethylstilbestrol which is another huge problem.
As a Family Nurse Practitioner and as a surgical menopausal woman who is on HRT I can tell you that many woman continue to suffer dramatically from the decision to not take HRT. Unfortunately since the OB-GYN field is still pervasively a male dominated physican speciality that doesn't give a crap about menopause or it's symptoms, there is little hope on the future horizon for options to relieve said symptoms. If Menopausal symtpoms and the present HRT recommendations involved men, the penis and erections cutting research would be taking place 24/7 to develope a satisfactory solution.
I see many many comments here like "If HRT isn't safe, then why is birth control safe?" Well... IT IS NOT SAFE! "Combined oral contraceptives are carcinogenic to humans" according to the IARC. Please, if you use any type of hormonal contraceptive, do some research. I recommend reading this Wikipedia article. It has some great information and links to further sources.
I don't think you can generalize about whether menopause is easy to manage or not. Each person is different and one size does not fit all. For some, it is debilitating. Also, when a woman has to work the mood swings can be particularly difficult. I have seen some women almost lose jobs because of severe symptoms without HRT. For those women with or without severe symptoms who do not have the pressure of working, the process can be much easier. I have strong objections to physicians who give a blanket no to women who are requesting HRT without exploring their symptoms and lifestyle issues.
Every woman who goes through menopause has different symptoms. At 48 years old I had suicidal thoughts, depression, debilitating headaches, hot flashes, memory loss, hot sweats at night, extreme tiredness, and very little sleep. I tried diet and exercise but HRT was the answer for me and later I found human estradiol or 17-beta estradiol which targeted all the symptoms. No progestrin. My gyn doctor wants me off it and I've tried to but the symptoms come back and I need to work for a living. No one wants to work with a raving mad woman! I still continue to diet and exercise and look forward to the day I don't have to wear an estradiol patch. I'm glad the breast cancer rates are down. There is a small history in my family but it usually hits in our late 80's. So I know the risk I'm taking but I also want a life! Thanks for letting me express my opinion on this subject.
Now, should women fear that birth control pills can effect their likelihood of getting breast cancer? There are studies that show both ways...what do we trust?!
Ladies Choose Life!! At 38 yrs old I was diagnosed with breast cancer, hormone positive, and treatment took be into menopause. Now I am an eight year breast cancer survivor. Menopause symptoms, and I have them all, are nothing compared to chemo, surgery, radiation etc.... Believe me!!!!
I began taking HRT in 2001 to curtail for symptoms of menopause. Never missing a yearly exam or mammogram my OBGYN found a lump in my breast in 2003 and immediately took me off HRT.
One lumpectomy, Brachey therapy and eight brutal chemo treatments I am now 3.5 years clean. I am convinced that the HRT was a huge factor in getting breast cancer. I hated the hot flashes the weight gain and the sleepless nights...but not any more...I'm 59 and going stronger than ever! It wasn't a pretty sight with sweat pouring down my bald head but hey.. I'm OK now..
God Bless all of the breast cancer survivors and never, ever give up hope.
My mother was a control group participant of the Women's Health Initiative (WHI). She had a hysterectomy when she was in her 40's and has taken estrogen ever since. She is now 81 years old. She has never had breast cancer. The bone density test she had done earlier this year showed that she was in the best category possible for someone her age.

Although there was much publicity about the WHI study and the increased risk of heart disease and cancer among participants, later on there was very little publicity about how flawed the study was. (Postmenopausal women placed on higher dosages of HRT who had not taken it previously.)

Based on this and my symptoms that could not be controlled by many of the alternative therapies listed in postings above, I started the lowest HRT dosage about 6 months ago and could not be happier. I'll take my chances. My quality of life now is worth the risk in relation to breast cancer for which I am probably at low risk of developing.

A 14% drop in the diagnosis of breast cancer is significant. However, what caused the cancer in the remaining thousands of cases? Are certain people more at risk than others? What other factors play a part in anyone developing cancer? Is it the polluted air we breath, the water we drink or the food we eat? What impact does our genetic background have on this and other health issues?

I cannot see myself discontinuing HRT due to this latest statistic. I think that there are too many other unknown factors contributing to breast cancer.
Some people have asked about the pill and other birth control hormones and their affect on breast cancer, yet do we not recall that there has been publication that being on the pill reduces the chance of getting ovarian cancer?!?!?

As my mother had ovarian cancer, but was fortunate enough that the cancer was in a water-filled cyst that kept the cells from spreading, and the MUCH higher rate of death with ovarian cancer, I would wait until more conclusive testing came out. the way, yes go get the CA125 test but realize that it's not a 100% proof test. It would not have caught my mother's cancer.

What is important is to be your own best advocate. We can catch breast cancer much faster than we currently detect ovarian cancer. Know what runs in your family and what risk factors you have.

My belief is that the medical research is still to inconclusive to jump on or off medications.

Is there not also a correlation in women becoming more educated about their health, more assertive about doing their own research, and choosing healthier lifestyles? I don't think we can point to HRT as the culprit.

Just look at research we've seen in recent years: eat eggs, don't eat eggs. Drink red wine, don't drink alcohol. Eat chocolate, don't eat sugar.
In response to Fernando Hernandez question if anyone can tell him why his wife got breast cancer even though she never took HRT in her life: The studies correlating lifestyle choices to cancer are just that - a correlation. It can be a stronger one or a weaker one but it is never possible to "prove" either way since there are way too many factors that go into a person's life history that could have added to the likelihood of getting cancer. Please do not dismiss important scientific correlations that can help save many more lives by having women consider twice before going on HRT. Cancer can be caused by a whole number of factors, many of them that start out being genetic that we are not aware of carrying such mutations that can sporadically give onset to a certain cancer. Cancer is not one disease but a complex of many different aspects of the cells going array...hence, the difficulties even today to identify the reasons for each different cancer. We have to be patient and we have to help in the awareness for more scientific research. We have to also try to be positive in the face of hardship such as the case of your wife. I am sorry about her getting cancer but it is not a reason to become bitter towards possible breakthroughs in the understanding of the causes of cancer.
I work for a holistic women's health Clinic in Maine. If you can get your body to make your own hormones again, that's the absolute BEST thing you can do. And you can...with proper nutrition, exercise,stress reduction techniques and supplements, most women can start making their own hormones again. The symptoms you're experiencing will subside...they key is to get your body to start making its own hormones again--and it can be done.
Every woman's menopause is different. Mine is quite severe, and diet and exercise does not help. Not sleeping, severe night sweats and hot flashes, not thinking clearly have only been lessened thru HRT. I keep regular check ups with my doctor, I will stop when I feel I can function without it.
I am wondering, is this including all brands of HRT therapy, or just certain ones, and the dosage amount. The report seemed to be vague in this area.
My wife is a two time survivor of breast cancer and she too was concerned with HRT. After long debate and her struggles with menopause, she decided to go on a low dose HRT. It came down to quality of life. She has suffered so much with the chemo and now menopause, she has not felt well in years. That is until HRT. She now feels like "a new woman" and says that she would rather have 10 good years than 25 bad.
I was under the impression from my doctor that risks were largely associated with hormones that contained both estrogen and progesteron. Since I had a hysterectomy at age 49, I have been taking a low dose of estrogen only. Here is my dilemma. When I go off the estrogen my symptoms return. I can manage many of them, but the one that gets me the most is memory loss. And, sometimes I find I can't even put together a sentence.
At 39, I was diagnosed with stage 2 breast cancer. Prior to having my mastecomy, I had been on the birth control pill for many years. I often wonder about the risk I put myself in taking the pill every day. While undergoing chemotherapy, I saw an acupuncturist, who told me that the pill is not a biodegradable product, meaning it doesn't get flushed out of your body but rather stores it. I advise anyone I know of to get off the pill and find alternative methods of birth control. Going through breast cancer and the associated surgeries/treatments is very challenging when you are a mother to young children (my twin boys were 5 at the time). My hope is that we can raise the awareness of the risks associated by taking the pill and reduce the numbers of young women getting breast cancer, the same as we have done for post-menopausal women and HRT.
Sadly, what has NOT been commented on is what is the DEATH rate doing! The fact is, we already know that HRT can UNMASK tumors that are already there, but those patients on HRT have a BETTER SURVIVAL rate than those not on HRT.

So although identification of new breast cancers dropped (and the effect of a change in HRT usage is unknown), do those patients getting breast cancer survive it any better?

I ask my patients whether they want to IDENTIFY and TREAT a breast cancer or die of it...the answer, at least to me, seems obvious...

Nobody wants cancer - that's a no-brainer. But to say that HRT causes breast cancer is unfair. That it may unmask a tumor that is already there may be more accurate.

Unfortunately, the media fear storm has effectively taken the HRT option away from many women suffering with menopausal symptoms.

I am NOT an HRT salesman...I personally counsel my patients about many options, many of which are NOT HRT. But, I also try to give them objective data, and not just media fear...

My two my soapbox...
It's unbelievable how narrow minded people can be. Birth control pills may increase the risk of breast cancer but they also prevent unwanted pregnancy, lowers risk of ovarian cancer, likely lowers the risk of colon cancer, significantly helps women with painful or heavy periods, the list goes on. So, yes there is an increased risk but the ABSOLUTE risk is low (a chance of 2/5000 is twice the risk of 1/5000 but the absolute risk in both of these examples is still quite minute). There is a risk of dying when you drive to the grocery store. A risk of liver failure from taking too much Tylenol, a risk of kidney failure from takting too much Advil, etc.... The absolute risks from these examples are low as is the risk of breast cancer from taking HRT. Women need to know that if they take hormone replacement therapy there risk of breast cancer doesn't immediately go to 100%. They should also know that they have a risk of breast cancer even if they don't take HRT (in the women's health initiative the placebo group that took no HRT had annual rates of invasive breast cancer of 0.28%). It boils down to deciding if you want to have to deal with hot flashes, vaginal dryness, or mood swings or accept the real but small risk of an increased risk of breast cancer. It's not as cut and dried as people are making it.....and just because Jane chooses soy, etc doesn't mean that her friend is wrong to choose HRT. It is a PERSONAL decision not a one size fits all. There is way more to the issue than a blog can cover and Dr. Gupta should know better than to present a mere 365 days worth of data..........
I am 29 years old and going through menopause because of radiation for vaginal cancer. Menopause hit me like a brick. I was miserable, could not sleep, could not function..I felt like my life was ending. I have to take HRT because I was abruptly thrown into menopause. I do plan on tapering off in a couple of years, but right now, I need it to function. For me right now, taking them is worth the risk. I remember how I felt when I wasn't. It's a difficult situation, and taking the risk could very well mean that you take "Quality of Life" over "Quantity of Life."
Considering that the Janapese don't even have a word for menopause in their vocabulary, maybe we should study what they do and apply it along with a healthy lifestyle, wieght loss if applicable and lose bras which prevent the lymph from draining out of the breasts and increase the temperature of the breasts. Maybe also eat more natural foods and natural soy products to relieve the menopausal symptoms. Several women in my family have breezed through menopause with no symptoms at all.
This is an interesting topic for me, as a post-op transsexual woman. I have been on HRT now for over six years. I do regular breast self-exams, mammograms, etc. but no medical professionals seem to have much data for people with my condition. I know many hundreds of trans-women in the community and none of them have reported having breast cancer. This is still a strong concern of mine, considering we (trans-women) generally take higher doses of estrogen prior to surgery, than post-menopausal women do.
People have asked about birth control also being a concern. I think it is. My aunt and my best friends mom were recently diagnosed with breast cancer. Both doctors have come to the conclusion that is was most likely because of taking birth control and having HRT. Being on the birth control did increase their chances, but I don't know by how much. Menopause is going to be different for everyone, and everyone needs to decide if HRT is worth the risk for their personal situation. Personally, I would look at it as if there was a 100% chance of me getting breast cancer, would I still do the HRT... but that's just me.
My sister died of Breast Cancer.

She took the first birth control pills offered in the 1960's.

There was a very interesting documentary on PBS called "The Pill" on the history of the birth control pill.

It seems that these very early pills had very high hormone levels - and many women back then (in the 1960's) came down breast cancer then.

Since then, the level of hormones in birth control pills has been lowered considerably.

I think breast cancer rates will continue to decline, because all the women who took those early, high-dosage birth control pills in the 1960's have either already died, or already been cured. Young women who took the "pill" in the 1970's and beyond are less affected.

It disturbs me that no one seems to have made this basic connection - although the connection based on hormone replacement therapy would seem to point to it.
I'm not a scientist, but I'm just curious about whether the study they conducted found a strong correlation between the reduction in HRT and breast cancer rates and whether the link was statistically significant and how many potentially confounding variables they controlled for. We can't just assume causality between the two rates. It may be that the reduction in HRT use corresponded with an increased use of some sort of alternative medicine and THAT's what's actually impacting the breast cancer rate reduction.

Anyway,it wasn't clear to me in reading Dr. Sanjay's post that the correlation between the two had been found to be significant.

Perhaps that should be cleared up so people understand the limitations of the study. I know that the full story does qualify what is being said, but it doesn't appear to be qualified in the blog.

It's not that I'm into HRT treatments or anything. I'm not even perimenopausal and don't plan on taking hormones when that happens.

It's just that there's enough sweeping statements about research in the news nowadays and it's important to me to make sure what's reported is accurate so that all of a sudden people stop thinking that breast cancer's an important issue.

My mom had breast cancer before menopause, so the link to reducing HRT does apply in all cases.
Everyone who's mentioned birth control pills should note that women who take birth control pills are still producing estrogen, while post-menopausal women are not. Birth control does not increase the amount of estrogen and, in fact, may reduce it in some women, because it provides a steady dose of hormones. Studies have shown no link between pre-menopausal use of oral contraceptives and an increased risk of breast cancer.
As my mother has taken HRT, and I have taken birth control pills and currently use a low-dosage hormone IUD, I have been following this story and these comments with interest. It would seem that in some cases, a hormone-free course of treatment would work quite well, but it's also obvious that women experience a wide variety of symptoms and what is good for one patient is not necessarily good for all. Hopefully the medical community will approach this matter constructively and respectfully, without judgment.

Also, it is absurd to link abortion to breast cancer. No statistics support any relationship between this medical procedure and the onset of cancer. The commenter is either incredibly naive or is using fear tactics to push an agenda. Regardless, it was irresponsible to publish that comment.
I went into early menopause at 43 with horrible symptoms. After reading everything I could from the American Cancer Society and discussion with my doctor I went on HRT (my mom had breast cancer at 59 and survived). I had 9 years of HRT, twice yearly check-ups with the doctor and yearly mammos. No cancer developed, but I did have a stroke which was attributed to the HRT. There should be more publicity and studies done regarding this link as well.
At the end of last year I began to experience the symptoms of menopause. Several months later I got to the point of being almost miserable and went to my doctor to find out about HRT. I filled a prescription but still did not take the medication. In April this year I was diagnosed with extensive hgh grade DCIS, a form of very early stage breast cancer and underwent treatments which ultimately resulted in a mastectomy. My DCIS tumor was progesterone+ and estrogen-. In the past few months my menopause symptoms flaired profoundly. I couldn't sleep and spent 24 hours a day feeling as if in the midst of an anxiety attack. I was so miserable that I decided to take the risk. I began taking the HRT every other day and within a week I felt so much better. Foolish, yes, but I feel like a human again.
HRT is exactly that hormonal replacement therapy. Meaning once you go through menopause your body no longer produces the hormones it once did. In younger women taking the contraceptive pill their bodies are set up to produce the hormones so it's just giving their bodies a continuous dosage. At least that's what I learned in my physiology class!
I am a 50 year old woman who has been peri-menopausal for approximately 8 years. I agree that proper diet and exercise as well as enough rest is important but they do not eliminate the symptoms of menopause in most women.

I have teenagers to raise, a full-time career, a husband and elderly parents, not to mention a husband and household.

Without HRT I had constant night sweats, which left me exhausted in the morning from lack of effective sleep. The hot flashes during the day left me quite weak.

Taking HRT is a personal decision but after taking 2 years off, I am back on HRT and finally feeling like a human being again. Don't put down what you haven't gone through.
I am one of those women who also experienced unbelievable hot flashes, multiple times every hour of every day and night. Since I have a history of breast cancer my doctor put me on low dose anti-depressants. They are not perfect but do offer some relief. My doctor has never been under the illusion that diet and exercise will solve a postmenopausal problems. I run marathons, exercise regularly, and eat a very healthy diet, and none of that has had any impact on lessening my hot flashes. But as I say, my doctor never suggested that my lifestyle was the problem and worked to find anything that would help me. It think its only people who have never been through menopause, or who are blessed with light menopause symptoms who believe the panacea is diet and exercise. More, much more research is needed on how to give women the relief they need from these debilitating symptoms.
Since many people have been asking, I (a 4th yr med student with family history of breast cancer) decided to do a search of literature correlating OCP use and later development of breast cancer. It appears that while there is small amount of conflicting data, most studies show that using OCP during the fertile years does not lead to increased risk of developing breast cancer later in life. Breast cancer is a phenomenon that increases with age irregardless of whether an individual has other risk factors. Thus, the greatest risk of developing breast cancer occurs in the setting of an older, usually postmenopausal, woman with high levels of unopposed estrogen. OCP users are usally young women, and are taking estrogen at a time when their bodies are naturally producing estrogen of their own. One notable exception though occurs in women who are carriers of BRCA1 (a mutation that is associated with increased risk of breast cancer). Studies show that these individuals are at increased risk of breast cancer when they take OCP as compared to BRCA1 carriers who had never taken OCP.
I am an extremely active and have a wonderful "clean" diet. I have had to take HRT just to be able to function. I resisted it for a year, but finally had to give in. Neither my marriage nor my job would have survived another year. Unfortunately as another blogger pointed out, women's issues are just not taken seriously enough to merit full investigation and treatment. We are not hysterical females. We have legitimate complaints. Those of you who are doing fine without HRT, count your blessings. But do not jump to judgment about the rest of us.
Doesn't the scientific evidence suggest that it is the progesterone in HRT that causes the breast cancer? Unless tehy are at high risk for uterine cancer, perhaps women should go back to estrogen replacement therapy?
i have found for me, that a black cohash concoction from Wild Oats Market
has eliminated hot flashes.
Black cohash was also endorsed by my GYN doc....Very Happy at 55...
I had been having the classic menopausal symptoms of hot flashes, night sweats, lost sleep for several years when I mentioned it to my physician; she asked me if I had breast cancer (which was odd, I thought)and said that HRT would dramatically increase my chances of it getting worse if I already had it. I had bi-lateral mammograms that showed nothing, so I went ahead and took HRT. After about 18 months I started feeling ill and it took another 18 months of suffering to get a correct diagnosis with ultrasounds. Mammos had shown nothing all along. Large needle biopsy, lumpectomy, sentinel node excision and 7 weeks of radiation and the constant terror of a recurrence or a horrible death by breast cancer are far worse than menopause ever was! Needless to say, I refused to go back on HRT after my ordeal, in spite of my doctor insisting that I do. That was 2 years before the link was discovered. I'm glad I listened to my own instincts.
It's great news to see significantly reduced rates of breast cancer. One can thank the seeming endless attention and fund raising the cause has garnered over the last 10-15-20+ years.

My one question is when does men's health, i.e. prostate cancer and heart disease get the same amount of attention and funding?
I am a young premenopause woman (42 yrs old). I've always been athletic and conscious of what I eat. I don't plan to take anything while I'm going through this time of my life. I've been depressed, hot, and up at night. I'll take my chances without the medication.
I went through early menopause, by the age of 39 my periods quit completely. I decided I wouldn't use HRT to manage the night sweats and hot flashes because I worried about the possible risks. By the time I was 42 I had severe vaginal atrophy in which I suffered cracks and fissures around my vagina, anus and in the crack of my buttocks. Topical Estrogens, cortisone and a number of other treatments didn't work and I went back on HRT. After a year of suffering, it took 4 months but everything finally started to heal and I feel like my old self again. A woman needs to make the right choice for herself. Thank goodness for my gyn doc..who gave me all the facts.
To people and or bloggers without experience ...
This is the most complicated decade of my life. Unless you've experienced it, you have no right judging it. And until medical science dedicates the necessary resources to understand and resolve the symptoms of menopause, we have no choice but to use the likes of Premarin. I tried NUMEROUS remedies ... I regularly exercise (for 20+ yrs), I'm a size 4, I eat only organic foods .. to have found myself on Premarin (for nothing else worked) has been an extremely difficult choice for me. I pray that the next bioidentical remedy I try will work. Attempting to reduce my Premarin intake in half, supplementing with 1/2 Triest leaves me symptoms all over again. I won't give up until I find a product more humane ... but trust me, I am more human with Premarin. In case you are interested, I had a full hysterectomy on my 45th birthday. I could not have children because I had been diagnosed with endometriosis at age 16 - an abundance of estrogen. I managed to avoid surgery with diet and exercise for some 20 years. I've not been so fortunate with HRT.
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I am delighted to see a 'drop' in breast cancer which may or may not be real as 3 percent fewer mammograms were performed that year.Also in general,many cancers tend to grow slowly at least initially.It is at this stage premature to conclude that such a so called drop within a year after a decline in the use of hormone replacement therapy caused a decline in breast cancer.A LONGER FOLLOW UP IS CRITICAL.More than one factor may be involved, but it is a great beginning.
I have been on HRT for 11 years after a full hysterectomy and I quit just recently. A lot of people talk about menopause as something simple that can be "treated with diet and exercise" but here is what most people either don't know or just don't talk about.

As I am a professional in neuroscience and am in menopause, I can report something that most doctors have not paid much attention to so far: when a woman gets a "hot-flash," it is not merely a "feeling" of hot but her entire body (internal organs and everywhere) boil in an instant; she may become wet from sweat tip-to-toe in an instant--like I do. This lasts for maybe 30-60 seconds and then she will switch from this heat to freezing fingers and toes for quite a while.

This is not a simple "hot flash" but a woman's body's thermal controls out of order as a result of menopause.

I have been wondering what the evolutionary reason for something like this might be, since putting the woman's body through such incredible changes several times per hour is VERY hard on the body.

As I have "full" menopause after the complete hysterectomy, one would suspect that menopause hot-flashes would stop very soon after there is no hormonal replacement, but they don't. This tells me that HRT induces "adaptation" in the brain--sort of like addiction.

Anyone who is familiar with what an addiction does to the brain and why this addiction is "for life," should now run back to the drawing board and re-evaluate what estrogen-withdrawal does to the human brain and once taken away (artificial HRT or regular estrogen that is stopped being produced by the body) and come up with some GOOD suggestion about what a woman is to do!
What about the link between breast cancer and breast feeding. It is not news that it had been discouraged for nearly 2 generations, replaced by bottles and now with a return to using the breasts for what they were intended for might have had an effect in the lower rates of reportable cancers in this generation?
Put my vote in the HRT category. I'm 41,post-hx at 38, did HRT for a year(having had hot flashes since 23)then stopped for a year.My 39th year was hell for me and worse for my five kids - I could not get control of the hot flashes and mood swings through even daily trips to the gym. Went back on HRT, even though my mom is a BC survivor. I take the lowest dose possible - and having weighed the risks it's still worth my sanity.
I thought I couldn't live without HRT, until I was diagnosed with breast cancer. Luckily, I had only a lumpectomy and radiation treatment; I take Arimidex which prevents me from producing my own hormones and guess what: I'd rather sweat several times a day and night than to go through a cancer diagnosis again.
How many types of HRT are available? Do they all increase the risk of BC? Are there any that mimic the normal fluctuation of the hormones during a woman's monthly cycle? That is the normal rise and fall of (each occurring at different times) estrogen / progesterone / testosterone. If so does it also increase the risk? Wouldn't that be the risk of a normal pre-menopausal woman? So are we really talking about an increased risk or trying to reduce the risk by neutering the woman
Dr. Gupta and staff, please know that this controversy is all about studies involving the products of one giant American company, Wyeth, manufacturer of Prempro and Premarin. We need studies on the FDA-approved bioidentical hormone regimens with Vivelle, Climara, Estrace, and Prometrium - please see Dr. Vliet's website about that. The 30% of menopausal women I call Les Menopause Miserables, of which I was one, need to know about the effects of these hormones that are a match for the ones we've lost, not the synthetic type that we already know increase our risk factors! When recommending HRT, at least send patients to these brand name bioidenticals, not Premarin and Prempro. Women who say "Why don't you just exercise and eat right?" are not experiencing the life-killing symptoms of those using hormones. If there's anything we've learned at this stage of life, it's that we need to make the most of life NOW, since these symptoms have been known to last into the 60's.
Sunny Hersh, author of Midlife Mamas on the Moon
This is amazing news, and will hopefully save thousands of women the horrors of a cancer diagnosis. I went through treatment for breast cancer at age 34 (no family history). Given that I was on the birth control patch, which delivered 60% more estrogen than advertised, I can't help but wonder if it was a contributing factor.

For those who are worried about menopause symptoms, I know they can be horrible, and I experienced it temporarily during chemo. But cancer, its treatment and the anxiety surrounding its return are also very debilitating. It kills 40,000+ women a year, and it is an ugly painful death.
Many of our foods and personal care products contain estrogen-like chemicals. One of the worst offenders is beef and dairy because the animals are given hormones and such that persist in the meat and milk. A woman's hormone balance is delicate, but we are surrounded by tainted food, pesticide and insecticide residues that are absorbed into our bodies and throw us into estrogen overload. These psuedo estrogens react in our bodies too. Diet is a key, but it is difficult in our money driven food production system to find food that is pure and natural and affordable. Menopause is not such a terrible thing in less developed countries. Seems like our lifestyle is the problem and HRT only removed a symptom of an underlying problem without getting at the real cause of why women's hormones got so out of whack in the first place that women are suffering these debilitating hormonal symptoms.
The pharmaceutical companies are out to make money. They cannot market naturally occurring hormones, so they adjust the chemical make-up in order to produce synthetic versions. They don't won't natural cures, which would put them out of business.
The non-scientific community tries to simplify lifes problems and point a finger at one culprit. The problem is there are many factors and there is not nearly enough information out to determine if HRT is actually "Causing breast cancer." In fact the genetic makeup of the person taking the treatment will determine if HRT increases the risk. So often these blurbs are posted, but where is the real scientific backup?? Can I see a peer reviewed article?
Most of you are significantly missing the point, and associating HRT with unavoidable cancer. Any patients who elects for HRT after hearing the risks/percentages explained is making a sound decision. As a doctor...I have no problem with my patients making an informed decision on what would be best for them. And diet and exercise...ha! Sometimes (most times), its not that easy...
The WHI (Womens Health Initiative, the study this is all based on)is often misinterpreted. The combined estrogen and progesterone arm of the study only showed 8 more cases of invasive breast cancer per 10,000 subjects compared to the placebo group. This represents a 0.08% increase in the incidence of cancer from using HRT. The estrogen alone portion of the study actually found a decrease in breast cancer with estrogen therapy.

The bottom line is, women need to be educated about the actual data, and then make a decision based on their quality of life. For many women, vastly improving their quality of life is worth it, and that is their decision.
I believe that we need to keep in mind that these studies have been primarily focused on combination HRT...estrogen and progesteron. Other studies have pointed to estrogen alone showing no increase in breast cancer risk. I am considered a 'high risk' as my mother and aunt and grandmother all had breast cancer. However, at 45, when I had to have a full hysterectomy, my dr put me on an estrogen patch, and it's been 5 years now. He feels strongly that the benefits of this estrogen only treatment outweigh the risks.

To address another's comment here...I too have a friend who got breast cancer at 39, died last year at 46. No known risk factors whatsoever. So I don't think we should be looking at "NO HRT" as a panacea.
I'm 51 & have struggled with devastating physical & emotional symptoms from menopause. I eventually went on BIOIDENTICAL hormones, HGH, DHEA, & vitamins plus I eat alot of vegetables, salads, fish, & cook only with olive oil. In addition, I get plenty of sleep, I do yoga, walk, scuba dive, read alot of books and swim 1/2 mile every morning. Bottom line, I feel much better, however, I still experience some symptoms on occasion. My husband has been very supportive & loving which has been a tremendous help. But I do believe each woman experiences menopause alone & on her own terms: no two women will have the exact same experience. It is, however, a very real passage for those of us who are around 50 & should be given much more attention from the medical community. Most doctors are so behind on this subject & it is incumbent upon the woman to seek out progressive & understanding physicians to help them navigate through her passage. I wish everyone of you out there going through menopause my most heartfelt blessings & encouragement.
In response to Tanya (a couple posts up from mine), the situation that you describe is termed pharmacogenomics. This science is still in its infancy stage. This science looks at a patients genes and rational drug therapy is given based on a person's genome. We may currently not even know which gene causes estrogen fueled breast cancer. For example, currently patients prescribed 6-mercaptopurine are screened for an enzyme that is responsible for that drug's metabolism. People without this gene cannot metabolize the drug and toxic effects occur. This is just an example of how this is used in practice today, and again, this science is in its infancy. Expect to see this used more and more the coming decades as the science progesses.
I read with interest the posting by Patricia Dumas, a close neighber (at The Jersey Shore.) My experience has been very much the same - while I kept on trying to tell my family and doctor how I feel-- grossly tired, run down, unable to wake up feeling good, etc. no one took it very seriously.

I did much reading & research online refusing to accept the "just suck it up" attitude. And lo and behold, found a very local medical practice that took my complaints very seriously. With complete blood work & bioidentical hormones I am starting to feel like life is worth living again. It is a very individual experience - so to those who say "live healthy, eat right and exercise", I spend a lifetime doing just that. And that doesn't prevent menopause symptoms in many of us, just like that would not prevent or cure a mental illness. Life itself is a risk, and with careful and informed decision makaing and good, forward-thinking doctors, I see nothing wrong with using bio-identical hormones to enjoy my life again.
I'm curious to know if this study is referring to synthetic HRT (Premarin for one)which I believe it is. I bet you would not see increased breast cancer rates in women whom used Bioidentical hormones. Would love to see a study on that. I believe bioidentical hormones will allow menopausal women to use hormones for relief without the increased risk of cancer ..... as long as the dose is prescribed correctly.
Menopause is a natural phenomenon. Yeah, you get symptoms but as your body adjusts, they pass. If you are always fooling your body, it will never adjust to life without those extra hormones. Why put yourself at risk to avoid a little discomfort? There are a few women who need help because their symptoms are extremely severe, but that should be the exception. As a society we are too dependent on instant feel-good results. As human beings, we need to quit messing around with our beautiful and complicated bodies by injecting or injesting chemicals that don't rightly belong. I'm 57 and I tolerated the discomfort as my body changed, but now I have none of those symptoms. I put on a couple of pounds and that was it. With a life-style change regarding eating and exercise, those pounds are gone. So get over it...
I have multiple sclerosis. A drop in estrogen makes my symptoms worse. I don't smoke, have a healthy diet and exercise, and I take a small maintenance dose of synthetic estrogen .625 mg. If I stop, not only will I have hot flashes (and God only knows what else?) but the MS will flare up.

Cancer is not prevalent in my family. I get regular mammograms, check for lumps, I'm small chested as well. I'm going to live on the edge... Give me my estrogen.
I have no history of breast cancer in my family. I'm a non-smoker and have lived a healthy life. At the age of 40, I was diagnosed with breast cancer after 2 years of intensive fertility treatment with hormones. I, without a doubt, know that this contributed to my breast cancer.
I have also had a hard time with menopause. I keep thinking the hot flashes and sleepless nights will be over soon, but seven years later I am still one hot lady. The only compensation is that before menopause, I had migraines and sore breasts for days before my period. So I live with hot flashes (my heating bills are minimal), I don't need sweaters, exercise everyday, and celebrate my lack of migraines. Sometimes I celebrate in the middle of the night when night sweats wake me up.
I took HRT for less than a year and a half, and was diagnosed with breast cancer. I'm an 8yr. survivor. HRT definitiely made me feel right with the world, but trust me it is not worth the risk. Facing your own mortality is a real eye opener. Nothing you experience is worth radiation and chemo.
I'm 54 and's a sweaty couple years but it beats umpteen years of a monthly period and it also beats taking chemicals to get through what is a natural process of life. thank you
I think you may want to comment on the other WHI study that involved women who had historectomies and received estrogen replacement therapy.
Why are the menopausal symtoms so severe nowadays, comparing to say, 50 years ago? It's mainly due to the unhealthy diet we have, consisting of processed food and meats / diary products loaded with growth hormones and antibiotics. And then we try to solve the problem by adding more hormones to our bodies. Menopause is a natural part of a woman's lifecycle. To ease the discomfort of these symtoms, try a more natural approach, such as acupuncture or supplements like black coharsh.
I had the ususal symptoms of hot flashes and night sweats. But they are not THAT terrible. Grit it out. You'll be fine.
From a tallk given this fall by Lita Smith, MS, RN, U of MICH; oncology symposium in San Diego:
--There is a recent decrease in both UK and USA breast cancer mortality at ages 50-69
--The study was done by WHI-Women's Health Initiative, with 16000 healthy women taknig prempro or placebo
--The study was stopped after 5.2 years when they found a 26% increase in breaast cancer with those taking the prempro
No research has come up so far has proven birth control pills are a factor in Breast Cancer.
SSRI's can help menopausal symptoms; effexor helped one woman when other therapies could not
Most doctors consider estrogen estrogen whether it comes from natural or chemical sources.
This all has to be an individual choice.

Stopping caffeine completely has turned my hot flashes to warm flushes, eliminated urinary urgency, helped moods. Each person is different. Hope this helps a bit.
Oh wonderful. Choose your poison, menopause negatively transforming your mind and body or cancer. Maybe if I eat more broccoli it'll be okay? :(
Do bioidentical hormones cause these problems or were they even included in this study?
I think it is fundamentally irresponsible to suggest that the apparent correlation between the stoppage in HRT and the decline in cancer rates represents a causal linkage without citing the relevant analysis that demonstrates this. What do the cited increases and decreases between 1975 and 2000 really mean? Are the base units annual rates? If so, what is the associated variance from year to year and is the change significant in this context? If so what is the confidence level? Many medical studies supporting or disputing treatments are of a dubious nature and neglect the important details associated with the analysis that was performed...
As the good news of the decline of the incidence of breast cancer emergers, it is unfortunate that Congress has so slashed Medicare payments for cancer care that many patients are losing access to necessary treatments, clinics are closing, satellite offices closing, and a crisis is emerging.
This isn't a debate about whether HRT is good or bad--this is about knowing risk and making informed decisions. What all women need is tons of research into the links between hormones and breast cancer. Only then can, on an individual basis, can we decide whether the risk is worth it. As a long-term birth control pill user, I am very concerned about increased risk for breast cancer, and I believe that the risks have probably be downplayed. Of course, preventing pregnancy is important too. I feel like I could be more comfortable with my choice if there were more studies on the long-term effects of birth control pills. Although science can NEVER give us complete "proof," I believe we need to make the research of HRT and pill connections to cancer a national priority. This study on HRT is about as convincing as an epidemiological study can be--as women we should all demand that our government increase funding for breast cancer prevention research!
I love all these people that HAVEN'T had hot flashes and all the stuff that goes with it on their bandwagons saying--eat right, exercise, etc. Try 5-10 hot flashes a day to the point you don't want to go anywhere or do anything or even go to bed at night and then see if you'd risk taking the smallest dose of estrogen and get your total life back!
I am 48 and had a complete hysterectomy 3 years ago. I have been on HRT ever since. I have begged my doctors to let me go off the patch and they have insisted that I remain on but never really gave me a good reason, that I thought made sense. I am extremely cold natured and I've gotta tell you, I actually enjoy the hot flashes!! After hearing the news today, I ripped that patch off my belly and my doctors can deal with it!
I'm 47 and had a hysterectomy six years ago. For five years I decided to "be tough" and experienced 30 or more hot flashes each day and slept poorly just about every night (maybe 3 hours sleep/night). I recently decided enough was enough, and started taking a very small dose of Estradiol (bioidentical) per day. I now have only about 2 'warm' flashes per day and I sleep 5 or 6 hours per night. I prefer to take the smallest dose possible, so I cut the dosage my doctor prescribed (1mg/day) into fourths (.25mg/day), and it works just great.
Homeopathy can help so many of the symptoms of menopause.....I encourage woman who have severe symptoms to investigate this as an alternative!
I suffered sleepless nights, hot flashes, and extreme mood changes for several years but refused to consider HRT due to the suspected cancer link. I've had good results with a Menopause Formula capsule purchased at the health foods store containing black cohosh root, alfalfa tops, licorice root and red clover tops. My advice, at age 57, is be prepared to try a few of these products and see if you can find one that works for you. This one was my third or fourth attempt. I also excercise every day, eat a healthy diet, take lots of vitamins, do yoga, and drink red wine and eat dark chocolate every day. I attended a seminar on non-conventional treatments and they recommended going to compounding pharmacists who can concoct herbal remedies to treat symptoms. I spoke to one, who encouraged me to continue using what I had found at the health food store, as it was effective in relieving my symptoms.
That person who wrote that menopause symptoms can be relieved through exercise and diet is one lucky woman! I have symptoms that come back as soon as I've tried stopping HRT. Without going into detail, the symptoms do not just involve hot flashes. There are other physical symptoms that can make your life hell. I have managed to cut my dosage requirements to manage the symptoms, but will not go back to the torture I was undergoing every day before HRT. It is worth the chance.
This topic is sensitive, and each woman must make the choice most suitable for them. My mother opted for HRT monitored by her physician. However, she also supplemented with additional herbal hormone treatments from her naturopathic MD, but did not tell either doctor of the other treatments. She just finished treatment for breast cancer. We feel fortunate that she caught it early with routine exams, but can only wonder if she increased her susceptibility by taking multiple treatments of HRT and not realizing the potential risk involved in doing so.
I took HRT for menopause. I also got breast cancer with no history of breast cancer in my family. The menopause symptoms were much easier to deal with than a lumpectomy, and axial disection, and 7 weeks of radiation! I don't care whay your menopausal symptoms are - quit taking those pills!!
I took Prempro for several years and got some relief from hot flashes.
In 2002, I was diagnosed.
Now take Tamoxifen which CAUSES hot flashes! But, hot flashes are a good trade off to be almost 5-yrs. cancer free.
Menopause is a part of a normal life that we should deal with. All post-menopausal women in my entire clan never used or tried HRT and they all lived and are living with comfortable life. Healthy diet, enough rest and regular exercise definitely contribute to less occurence of post-menopausal symptoms.
Anyone who thinks menopause can be treated with a healthy diet and exercise is living in a utopian dreamland. I'd rather have heathy bones and stay on HRT.

To Ms. Jennifer from Buffalo - wake up and show your mother some respect.
I underwent a complete hysteroctomy at the age of 28 and have been on HRT ever since. I am now almost 67. I have yearly mammaograms, pap smears and last year a bone density test, which came back that I have the bones of a 30 year old! I tried several times to quit the HRT but had such a miserable "life" that I figure the risks are worth it. My skin is good, I'm thin and in excellent overall health and feel pretty much like I'm 30! At this point in my life I'm actually afraid to quit taking the HRT!
I totally agree with Christina Charleston -- HRT, Pill, AND hormones in milk products and meat contribute to high rate of breast cancer of American women.

I came to the USA from Russia in the early 90s, and was horrified how many American women were diagnosed with breast cancer. Sure, Russian women get breast cancer, but at about the same rate as other cancers, certainly not as it is here. So long before the HRT study results were published, I suspected that there was something terribly wrong with HRT and other factors mentioned above.

I went through menopause naturally, buy organic (or European) milk 100%garantee, but a woman can reduce her risk of breast cancer. And we should campain for a ban of hormones used in cattle, the way the EU contries did.
My sister died of breast cancer 11 years ago...she was on HRT and we were told that she had a estrogen-fueled tumor. Todays news is very important to families who have suspected that HRT was the cause of breast cancer in their family. I feel a sense of closure now as I better understand the reasons for her death.
Why do women who have no personal experience with menopause always have such strong opinions about it? It's time people realized that every woman is different. Some sail through menopause. Some are completely debilitated by it. Judging by my personal experience, as well as numerous other women I know, menopause symptoms can be serious enough to cause disability. When a person is unable to work and be productive, they will try anything, including risky treatments. It appears to me that this is a significant enough health and economic issue to warrant intensive research to develop safer therapies.
It is unfortunate that so many things that we think help us seem to in return cause cancer.

I would like to know what Dr. Gupta has to say about Mammograms now being discovered as potentially dangerous.

A new study has found that mammograms may also cause cancer due to the radiation involved.

Mammograms started in the 70's and also since then a sharp increase in breast cancer has also appeared. (As pointed out by Dr. Gupta)

Cancer can easily be detected through blood tests which many insurance companies won't cover because it is more expensive than a mammogram. Yet less dangerous from radiation exposure.

So all the things that are basically supposed to help women deal with hormonal issues and protecting our bodies from disease end up doing more harm.
I'm glad to see that many doctors seem to be changing their minds about the safety and effectiveness of HRT. For so long it has seemed as though they just assume that once women reach a certain age they should be on HRT to "protect the heart" or other such nonsense. I wonder how many women have had serious health problems due to HRT who didn't need to be on it in the first place. There are many types of phytosterols and herbs found in nature that help women without dangerous side effects. It's too bad we don't promote things like Wild Yam or Soy products more than we do as each are known to ease some of the unpleasant symptoms of menopause and PMS. Oh yeah, I guess pharmaceutical companies can't patent and profit from nature!
Thank God, I listened to my instincts that told me not to take HRT because cancer is prevalent in my family. My primary physician tried to convince me to take it and I said no. I can't imagine that it would be worth the risk of breast cancer to continue taking HRT.
I am 39 years old and forced into menopause due to cervical cancer. Does cancer worry me, absolutely, but HRT allows me to have an improved quality of life for my husband and my young daughters. I would be more willing to accept menopause if I had naturally reached that point. Where do women like me stand?
Back in the 50's, there wasn't any HRT. My mother was put on Miltowns to get her through menopause and she was sleepy all the time. Our family has no incidence of cancer and I certainly don't want to be the first. I am on Femhrt which I am weaning myself off because of this report. Hopefully there won't be any symptoms of menopause that I'll go through.
I'm one of those women who'll refuse to give up HRT because some quality of life is worth the increased risk. Before HRT I experienced chronic fatigue, sleep disturbances, hot flashes, severe muscle and joint pain etc... to the point I became disabled at age 45. I still have the symptoms, but they're not nearly as severe since I begged my doctor to give me injections of HRT.
I was of the understanding that it takes about 10 years for cancer to develop. How can a decrease in HRT in 2003 cause a drop in cancer in the same year or 2 years following?
How can the medical establishment be so painfully ignorant of all of the strategies and natural supplements used successfully by women around the world and here in the US that make menopause a relatively benign experience?
Rather than learn about the natural alternatives to HRT, they will likely arrive at another pharmaceutical treatment that will provide instantaneous relief and then have to be taken from the shelves after a high percentage of women die or suffer from it. After reading about these natural remedies, I went to the health food store and stocked up on soy products, dong quai, black cohast, essential fatty acids and cut out all simple carbs. I exercized, meditated to reduce the production of stress hormones, and I supplemented my calcium intake with calcium, magnesium, Vitamin D, VC and zinc. The result- I slept though the night and felt just fine thank you very much.
You don't realize how serious it is that you're taking hormones until you get breast cancer and they do the pathology during surgery and find your hormone receptive. I used hormones for fourteen years and was told it did more good then harm. You now have much better information available and need to pay attention. Because of early detection, I am a six year breast cancer survivor. Be smart and realize a lot of money has been spent trying to keep you free of cancer.
I love the dialogue going on here. But please ladies, whether you personally believe in HRT or not, do not presume to tell others what they should do or not do. We are each unique and no two people experience the same symptoms of menopause, in the same degree.

I had heard all the negative news about HRT a few years ago and told myself I would not use hormones when I hit menopause. After all, my mother and sister got though it fine, with almost no symptoms.

Then it began. I did try. I could almost manage the hot flashes and night sweats by keeping a fan blowing on me, and by keeping a fan next to my desk each day and wearing lightweight tank tops under a business jacket that I could remove when hot.

But I have a job that requires frequent meetings with clients in their offices. Try sitting in a serious meeting for an hour or two, with sweat dripping down your face, arms, chest and even legs, with your face getting redder and redder. Not a pleasant thing to have a client see or to have to explain time and again.

But the worst was the mental foggyness I experienced. Initially I thought I was experiencing early-onset Alzheimers; it was that bad. So bad that after about 9 months of constantly forgetting things, not being able to focus or remain on a task, I almost lost my executive job!

Within 2 weeks of HRT this all went away. I know that I didn't take the decision to start HRT lightly, but for me it was absolutely necessary.
Women have gone thru menopause since the begining of time. What are the most natural, time honered ways to minimize the effects?
Skimming through this blog, I have to add my two cents. No every woman will go through menopause the same way. Some will tolerate the symptoms and some will not.

As far as the decrease in breast cancer incidence, I would have to look at how the numbers were derived before relating it to the Women's Health Initiative Study. Just so everyone is aware, there were two sides to the study. One was women taking Prempro (which is a combination of estrogen and progesterone). The other was women taking Premarin (just estrogen). It was the Prempro arm that actually showed a significant increase in breast cancer. This increase was just 8 extra invasive breast cancer per 10,000 women per year. This can not equate to such a dramatic decrease in breast cancer as reported today unless there was a very, very large number of women who went off of _Prempro_ after the initial WHI study came out in 2002. I wish Dr. Gupta would discuss this study because this blog is very misleading.

To answer a previous question, most oral contraceptive pills do have a combination of estrogen and progesterone. The estrogen component is very high, however, and OCPs are not usually used as hormone replacement therapy in postmenopausal women. But OCPs are very appropriate for perimenopausal women.

My response is for information only and should not be used to direct therapy. Nor should it be mistaken as support for or against hormone replacement therapy. Usage of medication such as hormones should be individualized and be discussed with your own practioner.
Within the world of CAM (Complementary and Alternative Medicine) therapies, there are several good options that have valid studies to show their efficacy, such as the use of the herb black cohosh, and homeopathic microdoses of various plant, mineral and animal products that can relieve disruptive symptoms at menopause. A qualified Naturopathic physician or certified homeopath can assist with this.
The WHI study was with much older women who'd already gone through menopause without HRT -- they then put them on Prempro (or Premarin if they didn't have a uterus.) It was a bad study and doesn't (can't) reflect either bioidentical hormone use (estradiol via patch or pill or progesterone (Prochieve or Prometrium or from a compounding Pharmacy.)

What age group of women showed a decrease in breast cancer? It looks as if the same year that "so many women quit taking Prempro" (2003) is the same year that overall breast cancer rates went down. There was no time that passed.

Personally, I think that the media is hopping on this bandwagon once again and drawing a conclusion that isn't medically sound. I went through menopause prematurely. This raised my risks of osteoporosis, heart disease and dementia considerably if I don't take hormones. Do I take them in pill form? No. Do I use bioidentical hormones? Yes. Are my doctors supportive with this? Yes.

Prempro was overprescribed by doctors who didn't know much about menopause so yes it is good that women (and hopefully doctors) are taking time to research other options.

While some women may do just fine when they enter perimenopause and menopause as far as symptoms, many find that their blood pressure or cholesterol increases and/or they develop clinical depression or osteoporosis. There are many silent symptoms that can greatly affect a woman's life during this time.

Unless you are a woman and have gone through perimenopause or menopause, don't judge others who choose HRT. Hopefully, doctors will become more educated about all of the alternatives to Prempro.
Has anyone else read about the mouse breast cancer virus that is linked to human breast cancer? It is believed that the virus mutated thousands of years ago and is spread person to person like the common cold!!! The reason women in the U.S., Europe and Australia get far more BC than Asian women is because the house mouse species that carries the virus is far more common in those countries. The virus is found in 30-40% of breast cancer tissue samples in U.S, Europe and Australia compared to 12% in Japan and less than 1% in Viet Nam. It may account more than 1-in-3 breast cancers in the U.S.
Well, how much scarier can it get for women?!!! Now we will have to fear people and sneezes?! Or however else people spread it.
I read it this morning under Earthlinks Health section which is WebMd. It was not there tonight but could still be found by typing Mouse Virus Linked To Breast Cancer into the search box next to WebMd Health Search.
I actually thought two decades ago that alot of cancers are probably caused by viruses and could be spread commonly like a cold.
Less HRT may be key to less breast cancer? Wow! Breast cancer rates haven't dropped in Canada though? Estrogen comes from many sources - a BIG contributor being XENOESTROGEN (spelling?) released from plastics. Not to even mention ALL the other carcinogens in everything. So, perhaps the consumer, by choices they are making, isn't as dumb as the researchers & media etc. portray them to be. Pretty sure the insurance companies will really like this study because they will decide that HRT won't be a coverable expense anymore.
They don't want to be responsible for the illness or death of anyone now, do they?
The Womens' Health Initiative used conjugated horse estrogens and progestin. That is the arm of the study where they saw the increase with breast cancer and heart disease. However, I believe they are still studying the estrogen only arm. Also, the women in the study were mostly around 60yo and very possibly could have already had cancer and/or heart disease.Everything I have read about progestin is that it is bad and it is NOT progesterone, the natural hormone.
All women should investigate bioidentical hormones. Most doctors have never heard of them. It is important to use natural hormones, by the transdermal route and start early in menopause.
My mother had 2 types of breast cancer.
The second type was terminal.
I have been having hot flashes for 3 yrs. Everyone at work is used to me fanning myself. Those who complain about hot flashes and night sweats should live with someone with breast cancer. It makes menopause look like a cakewalk. If you can't handle nightsweats and hotflashes, how are you going to handle chemotherapy and radiation trmt? Cancer will affect those around you far more than menopause. (A supplement of Essential Fatty Acids - EFAs - is helpful for menopausal women.)
While the drop in breast cancer rates coincide with lower use of HRT, this is only one correlcation for breast cancer. As a breast cancer survior (18 months and counting) who was diagnosed with stage 1 carcinoma at age 60, I had never taken HRT and had a healthy diet. With no history of breast cancer in my family and no other predisposing conditions, I had been considered low risk. There are many other women like me for whom the HRT news bears no connection to our breast cancer experience and who want answers that explain the underlying causes of our illness.
I am a 57 year old woman who has used Estring to relieve vaginal atrophy, and it works great. Now, do I need to lump this remedy in the same class as oral HRT? I prefer not to give up my intimate life and I'm sure my husband would not be happy, either. But without the ring, it is almost impossible.
this is a huge question. My sister had breast cancer 3 yrs ago. I've been on hrt (vivelle-dot) for almost 2 yrs. It gave me my life back )no sleep, losing weight, anxiety possibly more dangerous than we thought?
As a perimenopausal woman for who no amount of soy or black colash or whatever helped any of my symptoms I have to say I am getting fed up with politics of HRT. Both sides are more rabid than they are informative and neither of them are helping.
The stat concerning the drop in breast cancer post 03 is interesting. It is hardly evidence of cause of an effect but it's interesting. On the other hand the WHI study which is always mentioned in relation to HRT was flawed. The median age was 60 and only one particular form of HR was in the study. So frankly what does it mean for those women in their earlier fifies on slightly different forms of HRT.
As for a personal story of breast of my better friends never lived to see menopause. She died of inflammatory breast cancer within the year of her diagnosis, never having touched HRT.
Wow, HRT increases estrogen and progesterone which increases risk of breast cancer? Pregnancy increases levels of estrogen and progesterone, too. So how come pregnant women aren't more suseptible to cancer (I checked: they really aren't!)? Obviously this is a complex issue and it seems like the best any woman can do is keep informed and weigh the risks and benefits and make her own informed decisions about this and other health issues. .
The reason why oral contraceptives don't increase breast cancer risk to the same degree as HRT is that although they contain estrogen, they inhibit production of estrogen by the ovary. therefore, they don't add significantly to the total estrogen exposure a women has in her lifetime.
Chemicals cause cancer. HRT is artifical - it's chemicals. I really hope CNN is doing more stories on this just based on the sheer number of responses you received to this blog. Here's where you should start. Just exactly how much research went into HRT before it was put on the market?? It certainly appears the research was conducted long after massive numbers of women were already on it. Here's a doc
whose done quite alot of writing about how inadequately drugs are researched before we're all used as guniea pigs.

Here's another good question. Which has affected us more - HRT or terrorists?? We need to get our priorities straight!
Obviously women differ in their reaction to loss of hormones. Some barely notice and others are incapacitated. Suck it up doesn't cut it for the latter. Unless you have walked in thier shoes, you cannot tell someone who is suffering to diet-exercise-suck-it-up. How about lop off the breasts and use HRT. Best of both worlds.
Frankly, after a hysterectomy 20 years ago at 40ish I took estradiol and gradually quit 2 years ago in the cancer scare. I am miserable.
Quality of life is very important. Living longer in misery seems not an option.
Young women have been told they have nothing to fear with using oral birth control for as many years as they want to. Some are even opting for no periods. Now there is some talk about the pill and breast cancer. Are these young women hearing this message yet?
I know quite a few woman who had breast cancer and none ever took HRT but all took oral birth control at some point in their lives.
I would encourage readers who are concerned about the risk of breast cancer for those who take oral contraceptives, to read the recently published study by the Mayo Clinical Proceedings.
Dr. Gupta,
I was put on Estradiol in June due to a low FSH and severe hot flashes. On Labor Day Weekend, I was hit with sharp chest pain that radiated around my back and shortness of breath--having worked in medicine for years, I knew I should high tail it to the ER.
You probably know the diagnosis--pulmonary embolisms in both lungs and two hospitalizations to get my coumadin regulated. Needless to say, I gladly took my hot flashes back and will never use estrogen again. My gyn is trying cymbalta 60mg to control the hot flashes. She says it is an off label use approved by the FDA. I was already on 30mg for neuropathy pain in my feet. The 60 mg is working well. Do you have any comment or concerns regarding this regimen? Thank you for all the information you share on CNN. I feel it has helped me cope much better with the autoimmmune problems I have. Merry Christmas to you and your family.
I dropped the HRT several years ago and started taking 8 to 10 of Dr Sears fish oil capsules a day, as well as sorta following the ZONE diet of his.

Menopause symptoms QUIT as long as I kept taking the fish oil and would come back if missed 2 or more consecutive days. No more hot sweats, low sleep, nerves, etc ! Now, I'm past menopause but still take some fish oil for health
I am very health conscious, and I never thought I would take HRT. My menopause symptons, however, were incredibly bad. To give you an example of how I was feeling - I decided to ask for HRT, hoping that it would shorten my life. The change has been tremendous. I feel like myself again. My life is worth living once more.
I would not take HRT because my sister about 3 years ago got breast cancer which which was fueled by her hormones. She went through hell and now is taking painfully monthly shots in the stomach to keep herself in menopause stage. She was 41yrs old at the time.
In the spring of '98 (i was only 44)I suddenly started to gain weight (i was never overweight before)..I also started to sweat (not in flashes, but 24/7)..every single test came back "better than normal" - my little oriental doctor diagnosed me with chronic fatique syndrome (not that anybody knows what that is)..I've been very sick the last 8 years..every night i sleep with a fan a few inches away my i'm over 200 pounds (and i have no appetite)..i long came to the conclusion that medical science is nowhere)..i would've killed myself long ago if it not had been for my two now that really would be a that i assume i'm in menopause i'll tell one of my doctors what to prescribe for me (very small amounts of estradiol and prometrium - these are both human identical hormones)..i never worried about cancer..i always worried about heart problems..i wish more women paid attention to the fact that heart disease is the #1 killer of postmenopausal women..I truly am convinced i know more than any of the doctors i saw (after all i have two college degrees, and i'm an avid reader)..occassionally i ignore some of my outragous medical bills, because the doctor did nothing for me..Alzheimer disease gets more attention than very serious crippling conditions in women in their primes..i'd given up..historically, our gender didn't matter to i just do the best i can every day..and accept the fact that even if some of these doctors wanted to help me (and other women) they wouldn't know how..the knowledge is just not there..thanks
Why are women deciding this issue? It is no secret that it it is probably safe to take hrt for a short period, to be determined by your DOCTOR and you can probably safely take oral contraceptives for a short time in your life as well. This never was a patient's decision and I, for one, who was TOLD to take hormones for 30 years, would like to see a DOCTOR or two step up to the plate and apologize.
Then, instruct his/her patient's on what is safe.
Visit to read about the harmful effects of birth control pills. We need to know this!
I'm 48, sweaty, foggy, tired, depressed, and it's only going to get worse, but I will never, ever use HRT.

Like a few other women who have posted here, I watched my mother die a horrible death from metastatic breast cancer at the age of 52. Only a few years prior, her Dr. had prescribed HRT. Prior to her use of hormones, her mammograms were clean.

All I could think of after her death was that HRT had something to do with the onset/rapid spread of the disease. She was gone only a year after she was diagnosed. I damn the drug companies who will do anything to make a buck and who market any discomfort in life as a disease.

If my stats are correct, between 70-80% of breast tumors are estrogen dependent. How can ANYONE not see that taking HRT is like pouring gasoline on a fire? Perhaps many of us have tiny breast cancers that our immune systems keep in check; one study, in fact, revealed that 38% of a group of women autopsied after their deaths, and who had died of reasons unrelated to breast cancer, did indeed have tiny breast cancers at the time of death. The tumors, however, had never spread or caused a problem. Now imagine if they'd been keen to take hormones.

One thing I did find during many years of reading: for those hooked HRT, do not drink alcohol while using it. Combining both caused an almost 300% spike in the blood estradiol levels of women who were tested while drinking and taking hormones. This is from an older study, but I believe the "Love" website confirms this.

Menopause is temporary. So is life, but I'd prefer to see if I can wait out the symptoms and have a little more of the latter.
Just an fyi, it is my understanding that the WHI study was done on women in their middle sixties through seventies.
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