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Should women with a history of cancer take menopausal hormones?

A woman who has had cancer should talk with her doctor about whether to take menopausal hormones. Hormone replacement therapy (HRT) for menopause is not recommended for women who had or currently have breast cancer or endometrial cancer (cancer of the lining of the uterus). One of the roles of the body’s normal estrogen hormone is to make the cells in the breast and uterus grow. Researchers have found that women with a history of breast cancer who take HRT had a high risk of recurrence (having the cancer come back).

There’s not a lot of data from research studies on whether taking HRT after having other forms of cancer causes a recurrence, though it’s thought that some forms of cancer are more affected by hormones. If you have a history of cancer and are interested in taking menopause hormones, talk to your doctor about whether it’s safe for you. 

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Some women with a history of cancer should not take menopausal hormones. We know that when estrogen is given alone, without the balance of the hormone progesterone, there is an increased risk for endometrial hyperplasia, an overgrowth of the cells that make up the lining of the uterus. And that can increase the risk for uterine cancer (endometrial cancer). Estrogen can also fuel certain types of estrogen sensitive breast cancers, which means that women with estrogen-sensitive breast cancer should not use hormone replacement therapy. Estrogen therapy can increase the risk for other forms of breast cancer too, so we are cautious about prescribing it long term.

One of the roles of naturally occurring estrogen is to promote the normal growth of cells in the breast and uterus. For this reason, it is generally believed that menopausal estrogen use by women who have already been diagnosed with breast cancer may promote further tumor growth. Studies of hormone use to treat menopausal symptoms in breast cancer survivors have produced conflicting results.

In one trial, 434 breast cancer survivors receiving estrogen alone or estrogen plus progestin were followed for 2 years before the study was stopped because researchers concluded that even short-term use of hormone replacement therapy posed an unacceptable risk of breast cancer recurrence. Among these study participants, 26 women in the group receiving hormone replacement therapy had another occurrence of breast cancer compared with 7 women in the group receiving no hormone replacement therapy (16). In another study, which included 378 women who were followed for 4 years, 11 women receiving hormone replacement therapy had another occurrence of breast cancer compared with 13 women receiving no hormone replacement therapy, so the risk of breast cancer recurrence was not increased. A review of 15 studies comprising a total of 1,416 breast cancer survivors and 1,998 women without a history of breast cancer found no increase in risk of cancer recurrence with hormone replacement therapy use.

There is limited research on the risks associated with menopausal hormone use by women who have had other cancers, particularly gynecological cancers. One review of the published research found that no firm conclusion could be drawn about the safety of hormone use in women with a history of cancer. However, survivors of gastric and bladder cancer and meningioma may be at higher risk of a recurrence. Survivors of gynecological cancers may be at higher risk because these cancers tend to be more hormone-dependent, but more studies are needed.

This answer from the National Cancer Institute has been reviewed and/or edited by Riverside Health System.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.