Wednesday Bubble: Playing Russian Roulette – Hormone Replacement & Ovarian Cancer

Posted by on Nov 10, 2010 in HRT | 6 comments


Do we really need to burst another hormone therapy bubble? Or have you heard enough yet? If you are anything like me, I remain puzzled by those in the pro-HRT camp that keep on insisting that the data are incorrect and that hormone replacement therapy (HRT) is safe. Just last week I received a press release stating the following:

“Medical Experts Report Reduced Risk of Life-Threatening Diseases in Women Who Undergo Menopause Hormone Therapy…Menopause experts Drs. Lovera W. Miller and David C. Miller, claim in their new book, Womenopause: Stop Pausing and Start Living (O Books 2010), that Menopausal Hormone Therapy, or MHT, can help reduce the risk of serious health conditions such as heart disease, stroke, breast cancer, diabetes, and even depression and dementia. The Millers present new evidence that puts to rest the controversial statement by the Women’s Health Initiative (WHI) in 2002 that declared MHT (formerly known as Hormone Replacement Therapy, or HRT) was harmful and could lead to the same health risks that the doctors say it now helps prevent.”

The Miller present new evidence that puts to rest the contention that HRT is harmful. Really?!

Ironically, the very same day, I received word of data presented at the American Association for Cancer Research Frontiers in Cancer Prevention Research Conference this week demonstrating that both combination hormone replacement therapy (estrogen plus progestin) and estrogen-only hormone therapy increases the risk for developing ovarian cancer. Previous studies have linked the use of estrogen only hormone therapy to ovarian cancer so these findings are important.

This latest bit of information comes out of a European study of almost 127,000 women, 424 of whom developed ovarian cancer after 9 years of followup. Among current users of hormones during the start of the study, 69% used combination HRT and 18%, estrogen-only hormone therapy. Key findings included:

  • Increasing duration of use of any hormones was linked to an increased risk for ovarian cancer; women who used hormone therapy for 5 years or more had a 45% increased risk compared to women who had never used any hormones.
  • Current use of any types of hormones was associated with an overall 29% increased risk for ovarian cancer.
  • Type of hormone (combination versus estrogen only, regimens, how administered, as well as body-mass-index, smoking, oral contraceptive use and pregnancy history did not significantly affect risk.

In an accompanying news release, the lead investigator is quoted as suggesting that the link to ovarian cancer is consistent with recommendations that if women are going to choose to take hormones, that they take them for the shortest period of time possible.

This study joins the evolving database of evidence demonstrating that hormone replacement therapy, whether it’s combination estrogen/progestin or estrogen-only, can be a risky proposition in certain women. Want to read more trigger pulling data?

I don’t know about you but this woman is staying clear of HRT, hot flashes or not.


  1. 11-10-2010

    You know how crazy-making I find HRT and its now well-established links to cancers. I’m grateful to you for excellent coverage, attention, and explanation about HRT!

    • 11-10-2010

      Thanks Jody. It is fairly astonishing that the evidence keeps accruing and the non-believers keep believing the hype.

    • 11-10-2010

      In some respects, both sides could argue the same, no?

  2. 11-10-2010

    Liz, wanted to clarify my point with the links. I think that old ideas die hard, and this is what tends to happen when a doc is so invested in the idea of HRT. The rescue bias is rampant, where some do not want to let go of their entrenched notions of HRT benefit, despite the volume of harm or no benefit data. This is only compounded by the inexact nature of clinical research and its inherent uncertainties. You know I have blogged a lot about that!

    • 11-10-2010

      Thanks for the clarification Marya. I was not entirely clear where you were going with this.

      Data are ever changing as is their analysis. Bias is always introduced into the equation. But with regards to HRT, I would argue that the accumulating evidence from various sources beyond WHI has created an imbalanced risk-benefit ratio that requires careful consideration.

      Appreciate you taking the time.


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