Women worry about breast cancer, and for good reason. Almost everyone knows a friend or relative who has been diagnosed with this disease.
That is why the link between hormone replacement therapy (HRT) and breast cancer has captured headlines.
Premarin has been a best selling drug for decades. The company once advertised that more than 30 billion doses had been dispensed. If you add other brands of estrogen along with Prempro, which combines estrogen and progestin in its formulation, the numbers are even higher.
At the peak of its popularity, doctors prescribed HRT not just to alleviate hot flashes and night sweats, but also to prevent osteoporosis, dementia, heart disease and numerous other problems.
At one time, almost any woman with hot flashes would be given a prescription for HRT. Women who voiced concerns about the safety of hormones were told that they were essential for good health.
While estrogen can strengthen bones, the Women’s Health Initiative (WHI) was stopped early in 2002 because the data showed that women taking Prempro were more likely to suffer heart attacks, strokes and cancer.
Shortly after the WHI report came out we received this message from a reader whose doctor dumped her because she chose to stop her hormones:
“I have been on hormone replacement therapy for ten years, and my doctor has always been a strong proponent of HRT. I have asked about its safety in the past. He said that the news media highlight the negative results of studies and ignore the positives, and he has always convinced me to continue taking HRT.
“I called my doctor’s office to discuss the recent warnings and learned that he has not changed his position. I informed the nurse that I was uncomfortable taking the hormones and was going to discontinue them. I was then shocked to receive a letter from my doctor saying he will no longer treat me.”
This was not an isolated situation. Many physicians encouraged women to keep taking hormones regardless of what they read:
“I am a 61-year-old woman who just had surgery for breast cancer. I started on Premarin because of hot flashes and have taken it or Prempro for over eight years. At every annual checkup I asked about stopping the treatment and was always told: ‘The benefits outweigh the threat of breast cancer and even if you do develop it, it is curable if caught early.'”
At first physicians believed that women who took estrogen plus progesterone developed less aggressive, easier-to-treat forms of breast cancer. But a new analysis published in the Journal of the American Medical Association (Oct. 20, 2010) contradicts that belief. Researchers followed women for 11 years. Those who took Prempro had more aggressive tumors and were more likely to die from breast cancer as those taking placebo.
It is hardly any wonder that millions of women feel betrayed and at a loss for how to deal with hot flashes. To help them, we offer our Guide to Menopause with a variety of non-hormonal options.

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  1. TP
    Reply

    Very confused!
    I am 42 and had a full hysterectomy at age 36 – (everything removed due to endometriosis and prolapsed vaginal and colon wall)..no type of cancer. Immediately following the hysterectomy it was very difficult to feel “me” again but through trial and error, many forms of HRT and at times, no HRT… I finally got it right! For the past 3 years, I have been taking OBGYN prescribed Enjuvia, Premarin vaginal creme and a compounded progesterone from Peoples that a nurse practitioner prescribed when I complained of muscle aches and sadness.
    The nurse is in my family doctor’s office (who is an internist) separate from my OBGYN. This combination has been wonderful! I have felt normal, happy, energetic etc… that is – UNTIL my annual visit last week with my OBGYN… When he realized the creme I had mentioned through the years was in fact a compounded progesterone… he was so upset! He demanded that I stop taking it at once and proceeded to tell me that the unregulated hormones are causing all the breast cancer in women that we read about.
    Not only did I feel a little scared and nervous… going into day 8 of no progesterone creme, I feel low energy, with aching knees. Confused and wishing for my compounded creme from Peoples!
    PEOPLE’S PHARMACY RESPONSE: IT SEEMS THAT YOUR DOCTOR MAY HAVE OVERREACTED. WE DON’T KNOW THAT PROGESTERONE IS SAFE. THE RESEARCH DOES SUGGEST IT INCREASES THE RISK OF BREAST CANCER. BUT CLEARLY “ALL THE BREAST CANCER” CANNOT POSSIBLY BE DUE TO COMPOUNDED HORMONE CREAMS OR TABLETS THAT RELATIVELY FEW WOMEN USE.

  2. cpmt
    Reply

    Well I know of a 26 year old woman that had a stroke because of the birth control. Another woman who died of a stoke at 33 (she was complaining of headaches and fainting, the Dr. did not pay too much attention and two weeks later she was dead) …AND FINALLY a friend of mine have a daughter that has breast cancer… because birth control pills..
    SO, I think, and this is my opinion, that younger women should be careful too.
    PEOPLE’S PHARMACY RESPONSE: YOUNGER WOMEN SHOULD INDEED BE AWARE OF THE RISKS, WHICH ARE LOW BUT REAL. OTHERS MAY WONDER ABOUT THE BREAST CANCER RISK YOU CITE. HERE’S THE WORDING FROM THE PACKAGE INSERT (THIS ONE IS FOR YAZ, BUT THEY ARE ALL PRETTY SIMILAR): Although the risk of having breast cancer diagnosed may be slightly increased among current and recent users of combined oral contraceptives (RR=1.24), this excess risk decreases over time after combination oral contraceptive discontinuation and by 10 years after cessation the increased risk disappears. The risk does not increase with duration of use and no consistent relationships have been found with dose or type of steroid. The patterns of risk are also similar regardless of a woman’s reproductive history or her family breast cancer history. The subgroup for whom risk has been found to be significantly elevated is women who first used oral contraceptives before age 20, but because breast cancer is so rare at these young ages, the number of cases attributable to this early oral contraceptive use is extremely small.

  3. cpmt
    Reply

    I THINK they should do more research 10-15 years before you can say that bio-identical hormones can be proved are 100% safe. 20 years ago Dr’s told us that HRT was safe, look now how many % of women with breast y ovarian cancer. Only my opinion.

  4. GLSC
    Reply

    I have been taking Premarin since a hysterectomy at age 42. I am now 77, and am doing well on a recent reduction to 0.3 mg. There is no breast cancer in my family history. Is Premarin safer than Prempro? The cautions I read all mention Prempro by name, not Premarin.

  5. TP
    Reply

    I am so confused. I am 46 and have already gone through menopause. My last period was 4 years ago ans I have been on Bio-Identical HRT for almost 1 year. The last Dr. I saw was not too thrilled about HRT, but seemed to think since I went through menopause so young that the benefits would outweigh the risks.
    I am not one to take medications and am questioning myself with the HRT. I have noticed that I am not as anxious and I do sleep a little better at night. DO you have any comment on this?

  6. KH
    Reply

    Dr. John Lee did the research and proved beyond a doubt that bio identical progesterone is safe when taken in doses comparable to that needed by all women everywhere. If you read his books you would know that the research has ALREADY BEEN DONE.. the medical profession refuses to acknowledge his studies and obviously you do too… I am very disappointed with this forum in that you have not acknowledged or done your homework. Please read the work of Dr. John Lee. His research and studies were reported in the Lancet and were excepted to be a recognized proof that bio identical hormones ARE SAFE….!!!!!

  7. KH
    Reply

    Hi
    W
    hat you took was not progesterone and estrogen… it was only a synthetic version, that is where people get so confused. Doctors are issuing prescriptions for man made hormones… made from horse urine and progestins… notice the word… progestins ends in tins..i t is .not progesterone. Bio identical progesterone cream is all one needs in most cases… testing is usually recommended though to see how estrogen dominant you are before starting on progesterone to balance out the hormone levels.

  8. jgh
    Reply

    I took HRT (estrogen & progesterone) for 7 years and developed breast cancer! I say stay away from HRT.

  9. DJ
    Reply

    My mother died of breast cancer when she was 52. That was 36 years ago. I have 5 sisters; I was the history for menopause since my eldest sister had a hysterectomy years ago. I learned that Mexican Wild Yam Root helped with hot flashes and menopausal symptoms. I took the powdered root in a gel cap (which I capped myself) for years and breezed through menopause. So have my sisters. I have not taken any form of HRT and never will. There are too many natural substances available, one just needs to be informed. The information is available if one takes the time to find it.

  10. JB
    Reply

    Taking this information into consideration, what do women taking birth control pills need to be aware of when discussing concerns. Don’t birth control pills contain estrogen and/or progesterones? It’s my understanding that some women are just kept on the birth control pills until age 50 or so, to accomplish some of the same goals, so do the same risks apply or are the dosages safer?
    PEOPLE’S PHARMACY RESPONSE: YES, BIRTH CONTROL PILLS DO CONTAIN ESTROGEN AND/OR PROGESTINS. BUT YOUNGER WOMEN ARE AT MUCH LOWER RISK OF BREAST CANCER AND OTHER COMPLICATIONS.

  11. elv
    Reply

    It’s important to note that the estrogen hormones used in this study were not bioidentical hormones. The estrogen was derived from pregnant mare’s urine and the ‘progesterone’ was MPA ‘progestin’ not bioidentical progesterone.
    This is from the article in the JAMA:
    A total of 16 608 postmenopausal women aged 50 to 79 years with no prior hysterectomy from 40 US clinical centers were randomly assigned to receive combined conjugated equine estrogens, 0.625 mg/d, plus medroxyprogesterone acetate, 2.5 mg/d, or placebo pill. After the original trial completion date (March 31, 2005), reconsent was required for continued follow-up for breast cancer incidence and was obtained from 12 788 (83%) of the surviving participants.
    PEOPLE’S PHARMACY RESPONSE: COMPLETELY TRUE. AT THE TIME, PREMARIN AND PREMPRO WERE THE MOST COMMONLY PRESCRIBED HRT FORMULATIONS. THERE IS NO COMPARABLE STUDY OF BIOIDENTICAL HORMONES, SO WE HAVE NO WAY OF KNOWING IF THEY ARE SAFER THAN PREMPRO OR NOT.

  12. KATHLEEN
    Reply

    Are compounded or bio identical hormones as harmful as Premarin?
    PEOPLE’S PHARMACY RESPONSE: WE HAVE NO EVIDENCE EITHER THAT THEY ARE OR THAT THEY ARE NOT. IT WOULD BE A MISTAKE TO CONCLUDE WITHOUT DATA THAT THEY ARE SAFE.

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