Menopause happens due to a natural decline in reproductive hormones when a woman reaches her 40s or 50s and leads to hormonal and biological changes in the body including weight gain and hot flashes. The symptoms of menopause are commonly treated through hormone replacement therapy (HRT) which helps balance the hormonal levels in menopausal women.
During menopause, the ovaries make less estrogen and more progesterone which are hormones that control the monthly cycle. These hormones affect the heart, bones and vagina and the process of replacing them with the lab-made versions is called hormone replacement therapy. It helps provide relief from hot flashes and sweating, aids better sleep and reduces vaginal dryness and itching. The therapy also reduces the risk of heart diseases, osteoporosis and dementia among women.
According to Breastcancer.org, women who have undergone HRT are at an increased risk of breast cancer. There are two types of HRT- Estrogen HRT containing only estrogen and Combination HRT combining estrogen and progesterone and both have different effects on breast cancer. Though both types of therapy (estrogen and progesterone combined and estrogen alone) increase the risk of breast cancer, the risk is higher in case of combined therapy.
According to a Lancet Study, findings on breast cancer risk associated with HRT highlight that, the risk of developing the disease is twice as much in those who have undergone HRT therapies for 5-14 years as compared to those below 5 years.
So, what are the precautionary measures one should take in such a condition?
1. While opting for HRT, it is also critical to assess the risk of breast cancer through medical consultation for altering the dosage or duration of the therapy basis the risk.
2. Factors such as individual characteristics, risk factors, and severity of menopause symptoms, should be considered while weighing the pros and cons of HRT.
3. Patients diagnosed with breast cancer or having tested positive with an abnormal breast cancer gene should not opt for HRT because they can cause them to develop and grow.
4. For those who cannot undergo HRT, non-hormonal alternatives such as dietary changes, exercise, weight management, acupuncture or meditation can work for relieving symptoms of menopause.
Lifestyle changes
Apart from those who have undergone HRT and are at greater risk of breast cancer, all women should take care of their health through lifestyle alterations for reducing risk of breast cancer by:
* Consuming a healthy and balanced diet
* Engaging in adequate physical exercise
* Keeping your weight in control
* Limiting smoking and consumption of alcohol
* Avoiding exposure to radiation such as CT
* Avoiding environmental pollution
* Hormonal contraception including birth control pills can increase the risk of breast cancer and one must be careful while taking them
(Author Dr Rajeev Agarwal is Director, Cancer Institute, Medanta Hospitals)
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