Hormone therapy is a common option for managing menopausal symptoms, but it also comes with concerns about its potential impact on cancer risk. If you're considering hormone therapy, you may wonder whether it can affect your chances of developing certain types of cancer. In this article from Genesis Lifestyle Medicine, we explore how hormone therapy works, the different types of hormone therapies, and the research surrounding their links to cancer risk.
Hormone therapy and its effects
Hormone therapy (HT) is often prescribed to manage symptoms of menopause, such as hot flashes, night sweats, and mood swings. There are two main types: estrogen therapy (ET) and estrogen-progestin therapy (EPT). ET is used by women who have undergone a hysterectomy, while EPT is recommended for women who still have their uterus. Both therapies involve the administration of hormones to replenish those that naturally decline during menopause.
However, while hormone therapy is effective at managing these symptoms, there are concerns about its relationship with cancer risk. Several studies have been conducted to assess the potential risks of cancer associated with hormone use, particularly breast, ovarian, endometrial, and colorectal cancers. Understanding these risks is crucial when considering hormone therapy.
Breast cancer and hormone therapy
One of the most widely discussed concerns surrounding hormone therapy is its potential to increase the risk of breast cancer. The WHI study found that women who used EPT (a combination of estrogen and progestin) had a higher risk of developing breast cancer compared to those who did not take hormones. The risk was found to increase with the duration of use, but importantly, it decreased to baseline levels within three years after stopping hormone therapy.
Estrogen-only therapy (ET) has not been shown to significantly increase the risk of breast cancer. In fact, some studies suggest that women who use ET may have a slightly lower risk of breast cancer, particularly if they have no family history of the disease. However, this lower risk is not universal and can depend on individual health factors. If you're concerned about breast cancer risk, discuss your options with a healthcare provider.
Ovarian cancer and hormone therapy
The relationship between hormone therapy and ovarian cancer is more complex. While the WHI did not find a clear increase in ovarian cancer risk with EPT, other studies, including the Million Women Study, have shown a potential link between combined estrogen and progestin therapy and a higher risk of ovarian cancer. However, the risk remains relatively low.
For those using ET, studies have shown a slightly increased risk of ovarian cancer, but this risk tends to decrease over time after stopping the therapy. The risk associated with estrogen-only therapy is generally considered to be lower than that with combined therapies. Your doctor can help assess your individual risk and determine the most appropriate course of action.
Endometrial cancer and hormone therapy
One of the most significant risks associated with hormone therapy is an increased risk of endometrial cancer (cancer of the lining of the uterus), particularly for women using estrogen-only therapy. This is why women who have a uterus are typically prescribed both estrogen and progestin, which helps mitigate the risk of endometrial cancer. In women who use EPT, the risk of endometrial cancer is not significantly increased.
If you have had a hysterectomy and are considering hormone therapy, your doctor may recommend ET alone, which does not carry the same risk for endometrial cancer. It’s important to discuss your medical history with your provider to make an informed decision.
Colorectal cancer and hormone therapy
The effects of hormone therapy on colorectal cancer are less clear. Some studies suggest that estrogen may lower the risk of colorectal cancer, particularly in women who have used it for several years. However, the WHI study found that while women using EPT had a lower risk of colorectal cancer overall, those who did develop colorectal cancer had more advanced disease.
In general, observational studies suggest that hormone therapy may have a protective effect against colorectal cancer, although further research is needed to understand this relationship.
Does hormone therapy decrease or increase the risk of cancers? It’s complicated.
So, can hormone therapy decrease the risk of certain cancers? Well, hormone therapy can have a range of effects on cancer risk. While hormone therapy may increase the risk of certain cancers, such as breast and ovarian cancer, it can also have protective effects against other types, like colorectal cancer. The key is to work closely with your healthcare provider to assess the potential risks and benefits based on your unique health needs.
At Genesis Lifestyle Medicine, we are committed to providing you with the guidance and support you need to make the best decisions for your health. If you're considering hormone therapy, don’t hesitate to reach out to us for a consultation and explore your options.
