Combined hormone therapy:

Combined hormone therapy: Using combined hormone therapy after menopause
increases the risk of getting breast cancer. It may also increase the chances of dying from
breast cancer. This increase in risk can be seen with as little as 2 years of use. Combined
HT also increases the likelihood that the cancer may be found at a more advanced stage.
The increased risk from combined hormone therapy appears to apply only to current and
recent users. A woman's breast cancer risk seems to return to that of the general
population within 5 years of stopping combined treatment.
The word bioidentical is sometimes used to describe versions of estrogen and
progesterone with the same chemical structure as those found naturally in people. The use
of these hormones has been marketed as a safe way to treat the symptoms of menopause.
It is important to realize that although there are few studies comparing “bioidentical" or
“natural” hormones to synthetic versions of hormones, there is no evidence that they are
safer or more effective. The use of these bioidentical hormones should be assumed to
have the same health risks as any other type of hormone therapy.
Estrogen therapy (ET): The use of estrogen alone after menopause does not appear to
increase the risk of developing breast cancer. In fact, some research has suggested that
women who have previously had their uterus removed and who take estrogen actually
have a lower risk of breast cancer. Women taking estrogen seem to have more problems
with strokes and other blood clots, though. Also, when used long term (for more than 10
years), ET has been found to increase the risk of ovarian cancer in some studies.
At this time there appear to be few strong reasons to use post-menopausal hormone
therapy (either combined HT or ET), other than possibly for the short-term relief of
menopausal symptoms. Along with the increased risk of breast cancer, combined HT also
appears to increase the risk of heart disease, blood clots, and strokes. It does lower the
risk of colorectal cancer and osteoporosis, but this must be weighed against possible
harm, especially since there are other effective ways to prevent and treat osteoporosis.
Although ET does not seem to increase breast cancer risk, it does increase the risk of
blood clots and stroke.
The decision to use hormone therapy after menopause should be made by a woman and
her doctor after weighing the possible risks and benefits, based on the severity of her
menopausal symptoms and the woman's other risk factors for heart disease, breast cancer,
and osteoporosis. If a woman and her doctor decide to try hormones for symptoms of
menopause, it is usually best to use it at the lowest dose needed to control symptoms and
for as short a time as possible.