Hormone therapy vs Breast Cancer

"Is what I'm thinking true?"

Interpreting RISK is not something our culture understands very well.

And there's a chance you have never been taught how to interpret risk...and a greater chance even still that an adequate amount of time has not yet been allocated in your health appointment to review your OWN PERSONAL benefits vs. risk equation.

But you DESERVE a personalized hormone therapy "benefits VS. risks" conversation in order to make the best health decisions for you.

You also deserve a reminder that there are risks to everything; and risks to not doing certain things too.

It does not take long for any menopause conversation to arrive at the topic of hormone therapy, and for that conversation to veer towards breast cancer risk. So let's go there. Because breast cancer is a very real, powerful and overwhelming health topic. And no one wants to make a decision that will put them in the line of danger.

What's important to notice is that sometimes what we perceive as dangerous, needs to be first put into a personal context.

And we need to understand that there are risks to not pursuing certain options too.

No one I know wants breast cancer.

Most women I speak with on a daily basis also do not want to live with or suffer with vasomotor symptoms, vaginal dryness/atrophy or osteoporosis.

As you prepare to have an investigative conversation with your health care professional about the potential benefits and risks of hormone therapy, I invite you to keep the following in mind:

• What are the potential benefits of hormone therapy FOR ME?

• Help me understand what the potential risks are FOR ME?

• What else do I need to know/consider in order to make the best decision FOR ME?

BACKGROUND: BREAST CANCER

The biggest risk factors for breast cancer include:

1. having breasts

2. age (with every birthday, our risk of breast cancer increases; 1-in-8 (12.5%) is the lifetime risk of getting breast cancer; lifetime risk means 1-in-8 = the chances of getting breast cancer if you live to be 85. If you are younger than 85, your chances are LESS!)

3. modifiable factors including alcohol use, obesity and low physical activity.

Yes, genetics can play a role in assessing your personal risk but for many women (sometimes breast cancer survivors), the benefits of hormone therapy outweigh the risks.

The last thing our world needs is a whole of generation suffering and putting themselves at high risk for:

• vaginal atrophy: over 80% by the first 6 years of postmenopause; doesn't get better with time

• chronic UTIs: over 10 million doctor visits per year in North American are due to preventable UTIs

• incontinence: #2 reason a woman is admitted into long-term care

• heart disease: every 22 minutes a woman dies in Canada of heart disease and

• osteoporosis: current predictions for our generation is that 1 in 3 of us will break a bone due to osteoporosis)

• ....just to avoid a low risk rate of breast cancer.

This is why hormone therapy is such an individualized protocol, and why you can't make decisions based on headlines or hearsay; shared decision making is best made in partnership with an informed, experienced hormone expert.

Your health & hormone therapy: both deserve an individualized "benefit vs risk" assessment

Hormone therapy does not = breast cancer.

When a woman is taking hormone therapy, the incidence of breast cancer is low with estimates indicating a rare case of one per 1000 per year of therapy use. One additional case per 1000 is .1% increased risk. [Source: North American Menopause Society Position Paper on Hormone Therapy 2022]

Let's compare this to other risky life events, such as being killed in a motor vehicle accident which is 1 in 101 or .9%. This is still less than 1% but the chances of being killed in a car is 9 times greater than the increased risk of breast cancer while using hormone therapy (which, by the way, overlaps ONE, or more, of the highest risk factors for breast cancer = age.)

Speaking of age: the incidence of breast cancer goes up from 1 case to 3 cases per 1000 when a woman has been on hormone therapy for 5 years. That is .3%. Still less than half of 1%, and she is also 5 years older (age being a risk factor for breast cancer!]

Is this general risk what you thought?

You and your doctor can access more information via:

• Learn more at NestMembership.com (You deserve a soft place to land!)

• The North American Menopause Society (now called The Menopause Society) at www.Menopause.Org These stats related to breast cancer begin on page 780 of the Position Paper

• Your doctor might also want to watch this presentation by Dr. Robert Reid at the 2018 International Menopause Society Conference called The Perfect Storm.

• If your practitioner is looking to update their education and expertise in this space to help you and others like you in their patient panel, you can point them towards 1) the certification program at The Menopause Society or The Confident Clinician program.