Morag Currin
This question is asked fairly regularly during our clinical Oncology Esthetics® trainings about the use of bio-identical hormones vs hormone replacement therapy (HRT). So, let’s look at what is happening here with menopause that can be induced by chemotherapy.
During chemotherapy, women may have irregular menstrual cycles or amenorrhea (disappearance of menstrual periods). Some medications used in chemotherapy may also cause damage to the ovaries, resulting in menopausal symptoms or menopause.
When menstrual cycles end and ovarian hormone production drops dramatically this produces symptoms such as hot flashes and night sweats in up to 80% of women.
When symptoms are severe, they can have a negative effect on a woman’s quality of life and her ability to function properly.
In a clinical trial of estrogen plus progestin, hormone use showed decreased risks of fracture and colorectal cancer, but increased risks of heart disease, breast cancer, stroke, and blood clots. More recent reports suggest that combined hormone therapy may also increase lung cancer mortality. Estrogen alone does not appear to increase the risk of breast or lung cancer, but does increase risk of stroke.
There are plenty of women who do not want to take synthetically made hormones, so they seek out the alternative with bio-identical hormones. Bio-identical hormones are custom made drugs that use hormones that are structurally identical to the hormones produced by a woman’s body. Women who are considering these custom made drugs should use caution as there is no scientific evidence that bio-identical hormone therapy is any safer or more effective than conventional hormone therapy.
In summary, women who are considering hormone therapy for relief from menopausal symptoms should discuss risks and benefits with their medical professional. Hormone therapy still has a role for women who truly need it, and using it for the shortest amount of time necessary is likely to help reduce the risks.
If you’re interested in reading more about this topic, you can order Morag Currin’s book Oncology Esthetics here.
References:
Shifren JL, Schiff E. Role of hormone therapy in the management of menopause. Obstetrics and Gynecology. 2010;115:839-55.
Rossouw JE, Anderson GL, Prentice RL et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002; 288:321-33
Chlebowski RT, Schwartz AG, Wakelee H et al. Oestrogen plus progestin and lung cancer in postmenopausal women (Women’s Health Initiative trial): a post-hoc analysis of a randomised controlled trial. Lancet. 2009;374:1243-1251.
Anderson GL, Limacher M, Assaf AR et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA. 2004; 291:1701-1712.
Files JA, Ko MG, Pruthi S. Bioidentical Hormone Therapy. Mayo Clinic Proceedings. 2011;86(7):673-680.