Why Sylvia’s Not Giving Up on HRT

By Barry Nelson

Alarm bells will be ringing among post-menopausal women after new evidence of a link between hormone replacement therapy and ovarian cancer.Health Editor Barry Nelson investigatesTHIS week’s revelation that women on hormone replacement therapy have a slightly higher risk of ovarian cancer is bound to trigger concerns among older women.For years it seemed that HRT was a problem-free answer to the unwanted symptoms of menopause, such as hot flushes, vaginal dryness and night sweats.Doctors also believed that HRT, either a type containing the hormone oestrogen alone, or oestrogen combined with progestogen, protected against heart disease and the bone-thinning disease osteoporosis, which commonly affects postmenopausal women.But more and more worrying evidence is emerging from a massive research project – called the Million Women Study and covering 948,000 post-menopausal British women.First came evidence that being on HRT increased the risk of developing breast and womb cancer. Now scientists say that 1,000 British women may have died from ovarian cancer since 1991 because they were on HRT.Ovarian cancer is the fourth most common female cancer in the UK, affecting about 6,700 every year and killing around 4,000.The results from the research project suggest that over five years there is likely to be one extra case of ovarian cancer among every 2,500 women receiving HRT.Despite criticism by experts from the charity Women’s Health Concern, who point out that HRT actually saves many lives by protecting post- menopausal women against a number of diseases, the latest controversy is bound to hit the confidence of some women already taking HRT.But for one North-East woman, Sylvia, 54, from Darlington, it will take more than a cancer scare to make her give up her precious HRT. Since being prescribed HRT after she underwent a hysterectomy, Sylvia has felt completely normal and symptom- free.”Frankly, I can honestly say that after taking HRT I feel wonderful, ” she says.”Women will say here we go again, another cancer scare story about HRT.What should I do? Should I see my doctor?”But for her, the clear benefits of HRT outweigh any slightly increased risk of cancer.”I told the doctor I would fight him if he dares to stop my HRT, ” she jokes. I think the message should be that the benefits of HRT usually outweigh the dangers. The danger is that some people might panic. Whenever there are scare stories about the Pill, there is always a big increase in births afterwards, ” she adds.The mother of an 18-year-old son and 25-year-old daughter, Syliva says HRT has enabled her to keep distressing and unpleasant symptoms at bay. “I haven’t had any of the usual symptoms. I feel pretty normal, ” she says.According to the GP Research Database, the number of UK women using HRT halved from two million in 2002 to one million in 2005. Many have defected to alternative medicine, according to Mike Barker, who runs the Health Warehouse in Darlington.Mr Barker estimates that the number of alternatives to HRT has greatly expanded in recent years, following scares triggered by the Million Women Study.”Increasing numbers of women are looking for alternatives to HRT. Many are choosing to buy products with oestrogenlike properties which act in a gentler way than HRT, ” says Mr Barker. “The products use extracts from plants that contain oestrogen-like substances, these include soya beans and a product called Red Clover, which contains substances known as phyto- oestrogens, which are similar in structure to oestrogen.”Mr Barker, who writes a regular alternative health advice column in The Northern Echo, says the products sell very well and he seldom has any negative feedback. “Another popular product is something called Black Cohosh, which can help women control symptoms such as hot flushes and night sweats. If Black Cohosh is taken over a reasonable length of time the results appear to be quite marked.”The surge in women looking for alternatives to HRT occurred a couple of years ago in response to research suggesting a slightly higher risk of cancer for women on HRT.”As companies tried to meet the increased demand for alternatives to HRT the number of products on the shelves exploded, ” says Mr Barker. “We now have about 30 different products or combination of products compared to five years ago.”Regardless of the impact of this latest research, advice to women has changed in recent years. Doctors now advise women in the UK to take HRT for as short a time as possible and doctors no longer prescribe it as a first-line treatment for osteoporosis. But for many women – like Sylvia – a life without HRT is so unthinkable that they will gladly take the slightly increased risk of cancer.

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