Ideology needs to be separated from data
QUALITY use of medicines can only be achieved if ideology and emotion are separated from data and evidence, an ethicist says.
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HRT
The following articles have the tag HRT
Expert flags oestrogen-only HRT safer than combination
CANCER Council chief executive Professor Ian Olver has sparked controversy by suggesting that using unopposed oestrogen for hormone replacement therapy (HRT) is associated with a lower overall cancer risk than combination therapy, even in menopausal women who have not had a hysterectomy.
Behind the news - HRT use and cancer
Has the fall in HRT use affected colorectal or breast cancer rates in women older than 50?
Oestrogen-only HRT reduces breast cancer risk
WOMEN taking oestrogen-only HRT are less likely than non-HRT users to develop breast cancer or to die from the disease in the long term, US researchers say.
HRT access drops after a decade of bad publicity
ACCESS to subsidised HRT has contracted in Australia, while the evidence base detailing its optimal use has grown, the Australasian Menopause Society (AMS) says.
HRT link to breast cancer study questioned
AN INTERNATIONAL team of researchers has questioned the methodology of a landmark study that concluded combined HRT is linked to development of breast cancer.
HRT breast cancer risk linked to fall in screenings
MENOPAUSAL women who stop HRT are more likely to skip mammograms, a study suggests. Researchers noticed a slide in the number of women having regular mammograms, following a huge drop in the use of HRT, sparked by findings from the Women¹s Health Initiative trial in 2002 that showed a rise in breast cancer among those on the therapy. To investigate whether there was a link, the National Cancer Institute in the US asked more than 7000 women about their HRT use and mammographic screening between 2000 and 2005. They found reduction in the use of HRT ...
HRT patches prove safer than pills for stroke risk
THE RISK of stroke is reduced with the use of low-dose transdermal HRT patches compared to tablets in postmenopausal women, research shows. However, there is a slightly elevated risk for higher dose patches. A review of 70,000 medical records of UK women aged 50-79 years is the first to look at the difference in route of HRT administration in relation to stroke risk. Researchers evaluated more than 15,000 cases of stroke against HRT use, comparing patches with 50 µg oestrogen or less, and oral products containing 0.625 mg or less of equine oestrogen or less than ...
Long-term HRT use raises cataract risk
LONG-TERM use of HRT is associated with an increased risk of cataract development, researchers warn.
HRT no CVD benefit, review confirms
NEW evidence confirms the failure of HRT to offer cardioprotection in short term use by older postmenopausal women. A re-analysis of the Women’s Health Initiative data found those randomised to oestrogen plus progestin had a two-fold increased risk of cardiovascular disease within the first two years of use compared to those using placebo. A possible cardioprotective effect was found in women who started therapy closer to menopause, but only after six years of use. “Most women...start hormone therapy soon after menopause and generally use it for less than six years,” the authors said. ...
VTE and hormone replacement
VENOUS thromboembolism (VTE) is an important component of the benefit-to-risk equation in the use of postmenopausal hormone replacement therapy (HRT). Practitioners and women are often more concerned about breast cancer than thromboembolic complications; however, thromboembolic events are one of the commonest significant side-effects of HRT. This article summarises the data on the HRT-related VTE risk and factors that influence it. Both observational and interventional trials have shown a significant increase in VTE risk among current HRT users. 1 The Women’s Health Initiative (WHI) included clinical trials designed to ...
Trial links HRT with lung cancer
MENOPAUSE experts say most women taking HRT should not be worried about a post-hoc analysis of the Women's Health Initiative (WHI) trial linking the therapy to an increased risk from lung cancer. Researchers found that women randomised to combined therapy for 5.6 years were more likely to die from lung cancer compared to those on placebo. The increased risk related to only one type of cancer – non-small-cell lung cancer. Overall, in the study of 16,500 women, some 109 in the HRT group developed lung cancer compared with 85 given placebo, a difference that was not ...
Study confirms HRT increases ovarian cancer risk
EVIDENCE is mounting that HRT increases the risk of ovarian cancer, in addition to the well-established risk of breast cancer. A Danish cohort study of 909,000 women found those who had used HRT had a 38% increased risk of developing ovarian cancer, compared to never-users, over an eight-year period. They had a 44% greater risk of epithelial ovarian cancer. The association remained regardless of the duration of use, formulation, oestrogen dose, regimen or progestin type, or the route of administration. The absolute risk indicated approximately one extra ovarian cancer for every 8300 women taking hormone therapy ...
Study reignites HRT safety debate
AUSTRALIAN experts are divided over the findings of a study suggesting that the risks of HRT outweigh the benefits, even with initiation soon after menopause. The re-analysis of the Women’s Health Initiative trial disagrees with the so-called “window of opportunity” hypothesis which proposes that perimenopausal women may reduce their risk of coronary heart disease (CHD) with short-term HRT introduced early. Epidemiologists Dr Karen Canfell, from the University of NSW, and Associate Professor Emily Banks, from the Australian National University, said the study showed either adverse effects or no effect on CHD risk, adverse effects on stroke and ...
Avoiding short-term HRT ‘unjustified’
DOCTORS and patients are avoiding HRT despite recent evidence that short-term use early after menopause confers more benefits than risks, a leading gynaecologist says. Dr Barry Wren, a founding member of the Australasian Menopause Society, said that reanalysis of the Women’s Health Initiative (WHI) study showed the original conclusions were erroneous. He believed the pendulum of opinion regarding HRT use had swung too far, and more women were avoiding it than was warranted by the data. “Most doctors... have a concern that HRT will cause cancer,” he said. “But few have looked at the benefits and ...
HRT cancer risk less than five years
NEW research is casting doubt on the five-year time frame in which the use of HRT is considered safe, prompting one expert to suggest a shorter period of use may need to be recommended to reduce the risk of breast cancer. Professor Henry Burger, an endocrinologist and consultant to the Jean Hailes Foundation for Women’s Health, was commenting on a US observational study of 67,000 women. It found that oestrogen plus progesterone therapy was associated with a doubling of the risk of lobular cancer within three years of use. The study also found that the risk ...
Reflux risk for postmenopausal women on HRT
POSTMENOPAUSAL women who use hormone replacement therapy (HRT) are more likely to develop reflux, a study shows. New data from the Nurses’ Health Study revealed that women who had used HRT in the past had a 46% increased risk of gastro-oesophageal reflux disease (GORD) symptoms, compared to those who had never used HRT. Among the prospective cohort study of more than 50,000 people, 12,018 (23%) reported having symptoms such as heartburn or acid reflux at least once a week. Current users of oestrogen had a 66% increased risk compared to never users, while users of combined ...
HRT improves older women’s quality of life
OLDER postmenopausal women taking HRT for a year have improved sleep and sexual function, as well as reduced joint and muscle aches, a study shows. However, results from the Women’s International Study of Long Duration Oestrogen after the Menopause (WISDOM) showed only a modest improvement in overall quality of life. The WISDOM trial, designed to run for 10 years, was halted in 2002 because of concerns about cardiovascular events raised by results from the Women’s Health Initiative (WHI) study. WISDOM involved more than 22,000 women aged 50-69 years, recruited from general practices in Australia, New Zealand ...
HRT and breast cancer risk
Clarifying the links between hormone replacement therapy and breast cancer. BREAST cancer is a commonly occurring malignancy with a one-in-nine risk of a woman of being diagnosed before the age of 85 years. A possible increase in the risk of breast cancer is the most emotive issue associated with any discussion of HRT for postmenopausal women. BACKGROUND Before 2002, the most significant publication regarding the link was the 1997 Lancet paper of Beral and colleagues ( 350:1047-59 ), which was a collaborative re-analysis of available data, all of which was observational. ...