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The adverse effects of hormone replacement therapy
1Istituto di Ricerche Farmacologiche Mario Negri, Milan, italy. tavani@irfmn.mnegri.it
Drugs & Aging
|July 17, 1999
Summary
Hormone replacement therapy (HRT) use increases breast cancer risk with duration of use, but this risk declines after cessation. HRT effects on other cancers, stroke, and thromboembolism vary, with current use posing the most significant risks.
Area of Science:
- Epidemiology
- Oncology
- Women's Health
Background:
- Hormone replacement therapy (HRT) is used to manage menopausal symptoms.
- Concerns exist regarding potential adverse effects of HRT on cancer risk and other health outcomes.
Purpose of the Study:
- To review epidemiological data on the adverse effects of HRT.
- To assess HRT's impact on breast, endometrial, and ovarian cancer risks.
- To examine HRT's association with stroke and thromboembolism.
Main Methods:
- Review of epidemiological studies, including a large re-analysis of individual data on HRT and breast cancer.
- Analysis of data concerning HRT and endometrial, ovarian cancer, stroke, and thromboembolism risks.
Main Results:
- HRT use is associated with a 2.3% increase in breast cancer relative risk per year of use, which reverses after discontinuation.
- Unopposed estrogen increases endometrial cancer risk, while cyclic combined HRT mitigates this.
- No strong association exists between HRT and ovarian cancer; stroke risk association is debated but not consistently strong.
- Current HRT use, not past use, is linked to venous and pulmonary thromboembolism.
Conclusions:
- Most HRT adverse effects are associated with current or recent use.
- Long-term HRT decisions require individual risk-benefit assessment, considering personal risk factors and potential benefits for cardiovascular health and osteoporosis.