For Those With Hysdirectomies, How Safe Is The Estrogen Patch And What Are The Risks?

Oct. 19, 2007— -- Question from krlutgen:I am a 42 year old female who has recently had a hysdirectomy (full). I watched Dr. Snyderman saying she does not believe in HRT for menopause women and I'm wondering what is her opinion on this for me? I am on an Estrogen patch (just started). How safe is it. What are the actual risks? My doctor says it is safe because it is just estrogen (not progesterone). Is this true or would I be better not using anything and letting my body go through menopause? I'd appreciate any information you could give me on this topic. Thank you!

Answer from Karleen Habin, R.N., nurse consultant for OnCall+: Breast Cancer:I am going to answer your question with the data published on the NCI web site as posted below.

I think for those visiting this web site on breast cancer there are a few issues often raised -- I have outlined them here with resources listed below:

1) Is hormone replacement (HRT) therapy safe?
2) Is HRT with Estrogen alone safer than Estrogen + Progesterone for "healthy" women; i.e., women without a history of breast cancer or without a higher than average risk for the development of breast cancer?
3) Is HRT safe for women at risk for the development of breast cancer?
4) Is HRT safe for women who have had a diagnosis and treatment for breast cancer?
5) If I have a diagnosis of breast cancer and am having symptoms of menopause; what can I do to relieve these symptoms without HRT?
"Menopausal hormone use (sometimes referred to as hormone replacement therapy or HRT) usually involves treatment with either estrogen alone or a combination of estrogen with progesterone or progestin, a synthetic hormone with effects similar to those of progesterone.

The best evidence for the risks and benefits of menopausal hormone replacement therapy comes from the Women's Health Initiative (WHI), a large randomized clinical trial including more than 16,000 healthy women, sponsored by the National Institutes of Health (NIH).

Results from the trial published in 2002 showed that the overall risks of estrogen plus progestin outweigh the benefits. Among the risks observed after 5.6 years of follow-up were increased risks of breast cancer, heart disease, stroke and blood clots.

On March 1, 2004, after nearly seven years of follow-up, NIH stopped the estrogen-alone arm of the trial, concluding that estrogen alone does not appear to affect (either increase or decrease) heart disease, a key question of the study. In addition, estrogen alone appears to increase the risk of stroke and decrease the risk of hip fracture. No increase in breast cancer risk was observed during the study period."

"Although menopausal hormones have short-term benefits such as relief from hot flashes and vaginal dryness, several health concerns are associated with their use. Women should discuss with their health care provider whether to take menopausal hormones and what alternatives may be appropriate for them. The U.S. Food and Drug Administration (FDA) currently advises women to use menopausal hormones for the shortest time and at the lowest dose possible to control symptoms. The FDA publication Menopause & hormones provides additional information about the risks and benefits of hormone use for menopausal symptoms. This resource is available at http://www.fda.gov/womens/menopause/mht-FS.html on the Internet."

http://www.cancer.gov/clinicaltrials/digest-postmenopausal-hormone-use

http://www.cancer.gov/clinicaltrials/results/hrt-and-breast-cancer0204

http://www.breastcancer.org/questions/hormone_replacement.jsp