HRT and cancer: quantifying the risk

Conclusion

Since its origination, the reported effectiveness of HRT has fluctuated widely. The therapy has long been appreciated for easing the vasomotor symptoms of menopause. However, its long-term good—or harm—has yet to be clearly defined. Still, HRT remains potentially beneficial to many women, even though the percentage of patients taking it as prescribed may be quite low.^54,55

When the estrogen-progestin arm of the WHI trial was halted, investigators concluded that “there were more harmful than beneficial outcomes in the estrogen plus progestin group versus the placebo group.”¹¹ While it is only 1 study addressing HRT use, the WHI trial may portend a global decline in the number of women and physicians willing to risk adverse events to improve quality of life.

One thing is clear: The ubiquitous treatment of postmenopausal women with HRT is no longer desired. Rather, the goal should be individualizing medical treatment based on each woman’s specific needs and risk factors. Although HRT remains among the treatment options, other supportive medications also are available (e.g., bisphosphonates, SERMs). Clinicians should continue to follow the literature on the use of HRT in specific situations, and be aware of other ways of potentially enhancing longevity and improving the post-menopausal patient’s quality of life.

Dr. Montz reports that he is a paid speaker for Pfizer. Dr. Falls reports no financial relationship with any companies whose products are mentioned in this article.