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Q. I took bio-identical hormone replacement therapy (BHRT) to handle my horrible hot flashes. After taking it for three months, I started having pains in my breasts. A mammogram did not show any problems, but the recommendation was made that I stop taking the compounded HRT. The pain went away when I did so.
I did feel better while on BHRT. My doctor told me, though, that even compounded bio-identical HRT still counts as hormone treatment. Any thoughts?
A. For more than 50 years, physicians prescribed traditional hormone replacement therapy (HRT) for menopausal symptoms with the expectation that it would protect the cardiovascular system and the bones as well. The Women's Health Initiative (WHI) in 2002 revealed that HRT could increase the risk for heart attacks, strokes and breast cancer.
Bio-identical hormone therapy has not been subjected to the same careful scrutiny as the WHI, so its long-term safety is still a question. We believe that, in your case, stopping the BHRT was smart. Data from the WHI show that women who experienced breast pain or tenderness while taking HRT were at substantially higher risk for invasive breast cancer (Archives of Internal Medicine, October 12, 2009).
In general, women having a difficult time with menopausal symptoms are urged to use the lowest effective dose of hormones for the shortest time that they are needed. For more information on hormone pros and cons and other ways to deal with hot flashes, we offer our Guide to Menopause.
Thanks to my use of Emerita, a natural (made from yams) progesterone cream, I never had a hot flash in my entire menopause experience. I still use it, 10 years after menopause because there are proponents who maintain that it helps keep bone density. I have no proof of that, but I definitely know that I have never experienced a hot flash.
I am 60 years old and I put up with hot flashes, but without the Estring, a vaginal ring inserted into the vagina for three months at a time, I have such vaginal dryness that relations with my husband is not possible. Estring is a slow release estrogen that is released into the vagina and is supposed to stay within the vagina after the initial first three months of use. It took over two months before the dryness went away and I feel great, but I'd like to know if there are any dangers to be aware of? My doctor seems to think I can wear the ring indefinitely.
When using bio identical hormones, it's very important to find the right balance of estrogen and progesterone. Everyone is different and the doctor should work with you to fine tune your hormone regimen. I had the same problem which was solved by simply using more progesterone and less estrogen. I feel much better now that the hormones are balanced and my breast tenderness is gone.
I took ERT when going thru the menopause and developed cancer of the endometrium. No one else in my family has had cancer. I'm convinced the ERT caused the cancer. This was the regime with progesterone also.