The research findings
500,000 women were involved in the study over a 26-year period, from 1992 to 2018. The results showed that:
- 6.3 in every 100 women who had never taken HRT would get breast cancer from the ages of 50 to 69.
- 8.3 in every 100 women who took oestrogen and daily progesterone for five years would get breast cancer within this time frame. This is equivalent to one extra case of cancer for every 50 women taking HRT.
- There was one extra case of cancer in every 70 women who took oestrogen with intermittent progesterone (where progesterone was typically taken for 10 to 14 days per month).
- There was an extra case in every 200 women who took oestrogen-only HRT.
- These risks doubled for women who used HRT for ten years or more.
- There appeared to be little or no risk in women who took the treatment for less than a year.
- There was no increased risk for women who used topical HRT applied onto or into the vagina.
What this adds to previous knowledge
- The risks are greater than was previously thought.
- There is a different level of risk dependent on the type of HRT.
- The risk is greater the longer the use of HRT. The risk was defined as 'definite' from 1-4 years of HRT use, and 'twice as great' from 5-14 years of HRT use.
- The risk continues for longer after coming off HRT than was previously thought. Risk continues to be higher than normal for more than 10 years, being higher the longer the use of HRT continues.
What the authorities say
The Medicines and Healthcare products Regulatory Agency (MHRA) are advising women who are on HRT to be particularly vigilant for signs of changes to their breasts, and to talk their doctor about the revised risks when renewing their prescription of HRT.
The MHRA are also advising that:
- Women only use HRT for the relief of menopause symptoms that adversely affect quality of life.
- They use the lowest effective dose of HRT.
- They use it for the shortest period of time possible.
- They only use it as long as the benefit in alleviating menopausal symptoms outweighs the risks associated with treatment.
- This balancing of risk and benefit should be done regularly with their doctor.
Should women come off HRT?
This is something that women need to discuss with their doctors, to thoroughly assess the risks and benefits, as per the MHRA's advice.
Our advice is that women who wish to come off HRT do so as slowly as possible, preferably over a year or more, to reduce the symptoms caused by sudden withdrawal.
Should women swap from HRT to a natural remedy such as Menopause Support?
Menopause Support and other isoflavone products are natural and gentle. They give oestrogenic support that is not associated with increased risk of cancer, thyroid issues, or cardiovascular problems. They do not, however constitute a direct equivalent to HRT. Their strength is far less than that of HRT, and women swapping from HRT to Menopause Support will experience withdrawal effects from the HRT. The more suddenly HRT is stopped, the more extreme these withdrawal effects are likely to be.
Should women who are considering HRT use Menopause Support instead?
This should be discussed with the woman's doctor, to help understand the balance of risk and benefit to that woman.
Are women who are taking or have taken Menopause Support at increased risk of cancer?
No. All the research relating to isoflavone supplementation shows no increased risk of cancer.