New Government (USPSTF) Warning on Hormone Replacement Therapy Risks
June 3, 2012 by Robert Wascher
Filed under A Cancer Prevention Guide for the Human Race, Big Pharma, Blood Clots, Breast Cancer, Cancer, Cancer Prevention, HRT, Hormone Replacement Therapy, Hot Flashes, Incontinence, Menopausal Symptoms, Menopause, Progesterone, USPSTF, Weekly Health Update, breast cancer prevention, breast cancer risk, cancer risk, cancer screening, cardiovascular disease, coronary artery disease, dementia, estrogen, heart disease, memory, risk, stroke, women's health initiative study
A new report by a U.S. Government task force (USPSTF) recommends against the use of hormone replacement therapy due to serious health risks.
NEW GOVERNMENT (USPSTF) WARNING ON HORMONE REPLACEMENT THERAPY RISKS
As I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, there is now solid evidence that the most commonly used form of hormone replacement therapy (HRT) is associated with a significant increase in the risk of developing breast cancer, and that risk continues to rise with the duration of HRT use.
Like many cancer experts, I have taken issue with some of the U.S. Preventive Services Task Force’s (USPSTF) recent revisions of longstanding cancer screening recommendations, including, particularly, their 2009 recommendation that annual screening mammograms be started later in life than most experts have recommended (and continue to recommend), and performed less frequently among middle-aged women than most experts have also recommended. More recently, in 2011, the USPSTF’s blanket recommendation that routine PSA screening for prostate cancer be largely abandoned has not been warmly embraced by me, nor by many other cancer prevention experts, given that we still cannot determine, in advance, which men with prostate cancer will be helped by treatment for this disease and which men will not benefit (and, hence, may actually even be harmed) by being treated because they have an indolent form of prostate cancer that poses no threat to their lives (Does PSA Testing for Prostate Cancer Save Lives?).
Now, the USPSTF is weighing in on another controversial cancer-related issue: hormone replacement therapy. Prior to 2002, more than half of all American women took some form of HRT to treat the common symptoms of menopause, including hot flashes, night sweats, vaginal dryness, and irritability. As I discuss in my forthcoming book on the tragic history of HRT, The Manufactured Myths of Menopause and Hormone Replacement Therapy: A Legacy of Suffering and Death, the intentionally deceptive multi-decade marketing of HRT drugs as a panacea for the both the real and imagined consequences of menopause, and the skillful (if duplicitous) portrayal of menopause as a pathological disease that renders its “victims” something less than feminine, was only recently revealed to be a collection of gross distortions (to put it mildly) on the part of the dominant manufacturer of HRT medications. Thanks to the landmark findings of the enormous Women’s Health Initiative study, which was published in the Journal of the American Medical Association in 2002, we now know that long-term HRT use is clearly associated with an increased risk of multiple and serious health problems, including an increased risk of breast cancer.
The USPSTF is now about to weigh-in on the issue of HRT, in a paper that is to be released in the June 4th issue of the Annals of Internal Medicine. Unlike their other recent controversial pronouncements, however, I actually find the USPSTF’s new recommendations against the routine use of HRT to be very close to my own recommendations, and so I am including their review of the existing clinical research data on HRT in this column.
After comprehensively reviewing the data from 9 different prospective, randomized, placebo-controlled, blinded clinical studies (including the massive Women’s Health Initiative study), the USPSTF study group determined that both estrogen-progesterone (combination) HRT and estrogen-only HRT significantly increased the risk of stroke, potentially fatal blood clots (venous thromboembolic disease), gallstones, and urinary incontinence. Estrogen-progesterone (combination) HRT was also, once again, shown to be associated with a significantly increased risk of breast cancer, as well as a probable increase in the risk of dementia. (On the other hand, estrogen-only HRT, which can only be taken by women who have previously undergone hysterectomy, appears to actually decrease the risk of developing breast cancer, while both types of HRT also appear to reduce the risk of osteoporosis-associated bone fractures.)
Based upon the increasingly large amount of available clinical research data, HRT, of any type, cannot currently be recommended for routine long-term use, given the multiple and significant health risks associated with both estrogen-only and estrogen-progesterone forms of HRT. After decades of intentionally misleading advertising by the manufacturer of the two most frequently prescribed forms of HRT, and the manufacturer’s intentional co-opting of numerous women’s physicians over the years, the true risks associated with the long-term use of HRT have now become abundantly clear. I will have much more to say about this cautionary tale when The Manufactured Myths of Menopause and Hormone Replacement Therapy: A Legacy of Suffering and Death is published in early 2013….
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Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity
Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author
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