Understanding the Connection Between HRT & Cancer
- Hormone replacement therapy (HRT) is a common treatment prescribed to alleviate symptoms of menopause, however, it’s also associated with an increased risk of certain cancers.
- HRT is used to treat some of the side effects women experience during menopause — the time that marks the end of a woman’s menstrual cycles.
- There have been multiple studies conducted that haven’t found a link between hormone replacement therapy and an increased risk of cancer. However, there are a few studies that have found a correlation between the two.
But before we talk about HRT and its link to cancer, it’s important to understand what exactly HRT is and what doctors prescribe it for.Read More
Some women experience intense symptoms during menopause:
- Hot flashes
- Problems with sleeping
- Bone thinning
- Pain during sex
As a result, doctors may prescribe hormone replacement therapy, which controls the levels of estrogen and progesterone in a woman’s body.
Does Hormone Replacement Therapy Cause Cancer?
There have been multiple studies conducted that haven’t found a link between hormone replacement therapy and an increased risk of cancer. However, there are a few studies that have found a correlation between the two.
For example, a 2015 meta-analysis of 52 studies on HRT and ovarian cancer found that women who took progesterone and estrogen after menopause had an increased risk of being diagnosed with ovarian cancer.
The risk was greatest for women actively taking HRT and decreased in the months after stopping HRT. This increase in risk was still present for women who underwent HRT for less than five years.
Another example is a 2019 meta-analysis of 26 studies including more than 4 million women that also found a correlation between HRT and ovarian cancer incidence for women in the United States and Europe.
The correlation was highest in two subtypes (epithelial-stromal and endometrioid ovarian tumors). However, the association couldn’t be reproduced in women in other continents, including Australia.
There was also a 2017 study that found women on HRT had a 32% increased chance of developing serous borderline ovarian tumors. It’s also been determined that most types of HRT increase a woman’s risk of developing breast cancer.
It’s important to note that HRT is sometimes part of ovarian cancer treatment after a woman has had her ovaries removed.
“There is actually some data that suggests improved survival with HRT given to ovarian cancer patients after diagnosis,” Dr. Bobbie Rimel, a gynecological oncologist at Cedars Sinai Medical Center, previously told SurvivorNet.
In fact, in 2012, the results of a randomized control trial showed significantly improved survival in women with epithelial ovarian cancer who received HRT (estrogen) in addition to standard cancer treatment.
However, the routine use of hormone replacement therapy is also debated, as it minimizes the risk of osteoporosis, cardiovascular problems and sexual dysfunction, but the evidence is considered “too limited” to support it being used routinely.
Dr. Stephanie Wethington, a gynecological oncologist at Johns Hopkins Medicine, previously summarizes the confusion for SurvivorNet: “The data on HRT and risk of ovarian cancer are conflicting, with some studies showing no increase in the risk of ovarian cancer when taking HRT and others an increased risk. Even in studies which show an increase they do not show a marked increase, it is minimal.”
Contributing: Sophia Li