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Menopausal Therapy and Contraceptives

HRT and Contraceptives

Based on evidence from various studies, the Women’s Health Initiative (or www.whi.org) and the Million Women Study, there is a very clear connection between Hormone Replacement Therapy (HRT)/Menopausal Therapy and the risk of developing breast cancer. The Million Women Study found that current users of HRT at recruitment were more likely than never users to develop breast cancer (adjusted relative risk 1.66) (see Lancet 2003; 362: 419-27). The above mentioned studies indicate that the breast cancer risk increases the longer HRT is taken.

The International Agency for Research on Cancer (IARC), based on a comprehensive amount of evidence, has concluded that long-term combined estrogen-progestogen menopausal therapy causes cancers of the breast.

For women who do not have a history of breast cancer it is advisable to discuss the risks and benefits of taking HRT with your doctor in order to make an informed decision as to whether HRT is right for you. It is further recommended that you review your current treatments with your doctor on a regular basis to know if they are still your best option. If you opt for HRT, ask to take the lowest effective dose for the shortest amount of time needed to treat your symptoms.

HRT is generally not recommended if you have a history of breast cancer as HRT may increase your risk of a recurrence of breast cancer (see HABITS trial). Any decision to take HRT should, therefore, be discussed in detail with your physician.

Oral Contraceptives and Breast Cancer

An IARC Monographs Programme evalutation concluded that “There is sufficient evidence that combined estrogen-progestogen oral contraceptives causes cancer of the breast (most notably among young women)."