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Gynacology and Health

Menopausal Women, HRT, hormone therapy

If Estrogen Causes Cancer, Where is the Epidemic?

By Dr. W. Gifford Jones

June 24, 2007

What would I do if I were a woman at the age of menopause and read the headline, “Breast cancer drop linked to decline in hormone therapy”? I'd be scared as hell if I were already taking estrogen. And I'd consider flushing it down the toilet. But what should menopausal women do then if they have an whelming desire to kick the cat, or their husband?

In 2002, a study of 16,000 women aged 50 to 79 showed that hormone replacement therapy (HRT) increased the risk of breast cancer by 26 percent, stroke by 41 percent, heart attack by 29, cardiovascular disease by 22 , and it doubled the rate of blood clots.

These figures in a headline make your eyes pop out, but they're misleading. Newspaper headlines failed to point out that there were really only small increases in breast cancer, heart attack, stroke and blood clots among HRT users. For instance, there were only 8 more cases of breast cancer and 7 more cardiovascular problems for every 10,000 women per year of use.

On the plus side, HRT decreased the risk of fractures and cancer of the large bowel. Equally important, it cured menopausal symptoms such as hot flushes, insomnia, severe irritability and stopped painful intercourse.

But this blockbuster report in July 2002 was bad news for the manufacturers of estrogen. During the next year sales plummeted 38 percent.

The authors of a new study report that in the year following this calamitous announcement breast cancer rates decreased by 11.8 percent in women aged 50 to 69. These were the women most likely to take HRT. In the over 70 group rates fell by 11.1 percent. And for women who were under the age of 50 breast cancer rates increased by 1.3 percent.

Dr. Peter Ravdin, one of the authors of the study, says that “something went right in 2003 and it seems that it was the decrease in the use of hormone therapy.” But is it really that simple?

When I read this report I was as dubious of the results as Dr. Robert Reid, professor of obstetrics and Gynecology at Queens University, in Kingston, Ontario.

Breast cancer isn't like an infection that strikes suddenly. Rather, it's a slow-growing process that takes five years before a malignancy is large enough to be detected by mammography. And up to 10 years before the lump can be felt. So Dr. Reid questioned how could there be such an immediate drop in breast cancer in the few months after many women stopped taking HRT? It appeared to be an illogical association.

There is also a tendency for women to stop having mammograms once they stop taking HRT. This may result in fewer breast cancers being diagnosed.

I have also pointed out in the past that millions of women have been using Estrogen for over 60 years. One would think that if estrogen caused breast cancer there would be a raging epidemic of breast cancer. And this has not happened.

So what should menopausal women do? They must realize that these studies are just “associations” linking HRT to breast cancer. When the sun rises in the morning and we get up in the morning, that's an association, but it means nothing. For instance, years ago associations, such as damp air for one, were said to be the cause of tuberculosis. But then the real cause was discovered, the tubercle bacillus. As yet we don't know the cause of breast cancer.

I advise menopausal women without symptoms to forget about HRT. After all, if you don't have a headache why take Aspirin? But if they do have severe symptoms and they want to kick somebody, it makes sense to use HRT in the lowest effective dose for the shortest possible time.

Others who have been menopausal for several years may develop thinning of the vaginal lining from lack of estrogen. In this case local estrogen can cure this problem.

Medical Archives after 2008
Medical Archives before 2008

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, “90 + How I Got There” can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones