HRT/ERT has undergone a pendulum like effect in its popularity. When it was first introduced, it was thought to be a wonder drug and then the association with endometrial cancer was recognized. The addition of progestin to the regimen minimized this risk and it was again very popular. Recent studies have shown an association with breast cancer and an increased risk of other conditions resulting in a more conservative approach to the prescribing of this treatment. The absolute risk of HRT in women in their 50s with use for less than 5 years is low and those who have been menopausal for >10 years or in their 60s are at greater risk. The increased risks noted here involves the use of HRT for > 5years. Breast cancer is the most common cancer in women and the news that HRT increased this risk was the most shocking revelation of recent large studies. The risk was increased by 6.8 additional cases per 1000 women after more than 5 years of use of combined estrogen and progestin therapy. This risk was not increased in those women using estrogen alone. HRT also increases the risk of thromboembolic events, a fact known from the birth … Continue reading
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