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DiscussionWhat kind of plans are possible if you are looking ahead for many year
Osteoporosis & Bone Health | Last Active: Aug 3, 2023 | Replies (25)Comment receiving replies
Replies to "I had breast cancer that was driven by estrogen (95%) and progesterone (80%). Since one out..."
I can certainly understand your reluctance to go on hormones or to even consider recommending them since you have had breast cancer. There's still a lot we don't know definitively and the information out there is very confusing. What we do know is that the WHI was a flawed study and that the explanation of results was hyped and misrepresented. What was presented was the "relative risk" (I think it was somewhere around 25%) which made the risk seem quite high when in actuality, the "absolute risk" was determined to be an additional 8-9 people per 10,000, a very small increased risk. Now, any small increase in risk may be too much for some and I recognize and respect that. For those that need to arrest bone loss and are not happy with the other drug options, it's just one more thing to consider along with the risk/benefit ratio as each drug option would have.
Some other things to consider. Those on estrogen alone (only if you have no uterus) actually had a lower risk of breast cancer than those on estrogen and progesterone. There is some consideration that it may actually be the progesterone that increases risk. This needs further exploration.
The hormones used in the WHI study are different from what is generally prescribed today which are likely much safer. They used an oral estrogen, Premarin, created from pregnant mare urine. This formula contained several forms of estrogen, most of which would not be prescribed generally in menopause. Estradiol seems to be the safest in a transdermal patch at a low dose. This option bypasses the liver, unlike oral estrogen which must be processed through the liver.
The WHI study used a synthetic progestin which is now known to cause an increased risk. The safest progesterone available is micronized bioidentical progesterone.
When research studies are completed that suggest altering the course of previously held medical belief and practice, new protocols generally don't become common practice in the medical field for 15-17 years. We may be drastically behind the 8-ball here as many doctors still hold onto the decree of the WHI though there are some who are starting to shift their thinking and their recommendations.
Dr Avrum Bluming, an oncologist who has studied the research on HRT for decades has co-written a book called Estrogen Matters. He has many articles and interviews online that are very informative. Here is an interview that deals with the issue of HRT and breast cancer.
https://www.balance-menopause.com/menopause-library/explaining-what-the-evidence-shows-to-offer-choice-to-women-after-breast-cancer-with-avrum-bluming/
It's a complicated issue, no doubt. I just want to put it out there as an option to explore, research and consider depending upon one's personal situation and comfort level.
i was on Evista for several years when i was younger. My doctor took me off of it as she said as I got older the changes of blood clots and strokes increased and she didn’t feel the trade off was justified.