A large federal study on hormone replacement therapy (HRT) in postmenopausal women was halted on July 8, 2002 because the drugs caused an increase in the risk of invasive breast cancer.  There was also an increase in heart attack, stroke, and blood clots. There were benefits seen from HRT with a slight decrease in colon cancer and hip fractures. 

What To Do Now?

I would suggest you dust off your copy of the McDougall Program for Women book, which first came out in the fall of 1998.  The reported adverse effects of HRT and reasonable alternatives are thoroughly discussed in this book.  How did I know all of this long before this "new" study?  Scientific research repeats the same findings over the years, the truth surfaces for a while, and then it is buried by billions of dollars in advertisements from the pharmaceutical industries.  The reason most of my work survives the test of time is because I try to understand the basic science behind issues of nutrition and health. 

While hormone replacement therapy increases cancer and heart disease risk, these recommended healthy lifestyle changes actually reduce the risk of these illnesses, as well as other menopause-related problems

Estrogen-based medications were once routinely used to treat hot flashes but have been shown to increase the risk of breast cancer and other serious problems.

Although previous studies have shown that postmenopausal hormone “therapy” increases breast cancer risk, a new study published in the British Journal of Cancer shows that the risk may be greater than had been realized. Researchers examined questionnaires from 58,148 participants in the UK Generations Study for breast cancer incidence rates at menopausal age. Those who underwent combined estrogen/progestogen treatment the longest were as much as three times more likely to develop cancer than those who did not receive hormone treatment. Researchers stress that previous studies which underreported or ignored hormone therapies among their cohorts underestimated the risks.

The use of hormone replacement therapy to aid in menopausal symptoms has been a popular therapy since the 1960s. These hormones are praised in magazine articles and books, leading women to believe that they have no risks. However, even though hormone replacement therapy has some proven benefits, studies have shown that it also increases a woman’s risk of breast cancer, heart attack, and stroke.

There are always risks when you fool with nature, and we must be cautious when using any type of drug or hormonal therapy. For the best protection against menopausal symptoms, a woman should stay slim, exercise and eat a diet rich in cruciferous vegetables and other greens for years prior to menopause. If a hormone therapy is necessary, there are forms and amounts that are safer than others, when used properly, and every woman deserves to know the associated risks involved.

Hot flashes are a classic symptom of menopause here in the United States. Understandably, many women have concerns regarding hormone replacement therapy (HRT) due to the increased risk of blood clots, strokes, heart disease, dementia, high blood pressure, weight gain, depression and uterine, breast and ovarian cancer. So what's a woman to do? Carry a fan and suffer through? NO! I tell my patients that we can treat this very natural change of life with a very natural remedy: food.

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So when my patients ask me what they can do about hot flashes and other menopause symptoms, I point them to their plates. I encourage my patients to adopt a low-fat, no-added-oil, whole-food, plant-based diet and to trade in their fan for a fork.

A woman should consider HRT if menopausal symptoms adversely affect quality of life and lifestyle changes haven’t helped or can’t be followed. However, hormone therapy will not change life circumstances and stress maybe due to other factors, in which situation HRT may not be as helpful as one hoped.

Lifestyle advice: It is important to encourage women to adopt a healthy lifestyle which includes a whole food plant based way of eating oi the main, undertake regular exercise, aim to be normal weight, ensure adequate sleep, identify and address stress triggers and avoid risky substances such as alcohol and smoking. This will help women to reduce risks of lifestyle diseases such as breast, bowel, womb cancers, osteoporosis, heart disease, diabetes and dementia, the biggest killers for women. A healthy lifestyle will also help women come off HRT as their life circumstances change. (see Lifestyle medicine and menopause nutrition leaflets)

Women should be advised to make lifestyle changes alongside starting HRT.

Contraindications to HRT

Generally, a woman with a history of cancer (especially breast or womb) is not recommended to have HRT. If it is to be used, this would be a highly specialised decision made by a team of experts.

Similarly, a personal history of thrombosis is considered a contraindication for HRT. With a family history, certain tests may be needed before starting HRT.

A history of heart disease (ischemic heart disease, peripheral arterial disease) is considered a contraindication for the use of HRT.

Any hormone treatment in these situations must be individualised with specialist guidance and advice.