MHT RISKS AND SIDE EFFECTS
Knowing the full picture.
Current international recommendations state that taking menopausal hormone therapy (MHT) is effective and safe for most healthy women and that the benefits outweigh the risks for those who are experiencing significant symptoms from menopause.
In cases where MHT is associated with an increased risk, this usually means a very small increase for most women and will vary from one woman to another. This increase in risk is dependent on many factors, such as age, weight, alcohol consumption, smoking, lack of exercise and family history. Your GP or gynaecologist should help explain the risks and benefits of taking MHT.
Breast cancer
The risk of breast cancer with MHT has been misreported by the media based on the earlier Women’s Health Initiative (WHI) results in 2002. The type of MHT in this study is not generally prescribed today. The average age of women in this study was 63, many of whom had other health issues. Women who were close to menopause only formed a small percentage of the study group. This media misrepresentation has left some women confused, anxious and reluctant to take MHT during perimenopause and menopause. In the decades that have passed, new information about MHT has meant doctors can better understand the risks and benefits associated with MHT and, for most women, the benefits of taking MHT outweigh the risks.
Oestrogen-only MHT causes little or no additional risk of breast cancer. There is a small additional risk of developing breast cancer when taking oestrogen and progesterone MHT for longer than five years.
If you have been diagnosed with breast cancer, you should not take systemic whole body hormone therapy. Vaginal oestrogen may be acceptable following discussion with your oncologist or breast specialist.
Venous thromboembolism (blood clots)
MHT patches and gels are not linked to an additional risk of developing a blood clot. If you are already at a higher risk of blood clots (for example, if you are a smoker or obese), then you may be offered patches or gel rather than tablets. Tablets are linked to a higher risk of developing a blood clot (NICE, 2021).
Cardiovascular disease and stroke
Studies show that starting MHT before the age of 60 does not increase your risk of cardiovascular disease. MHT tablets (but not patches or gels) slightly raise the risk of stroke. It is important to remember, however, that the overall risk of stroke in women under 60 is very low. If you are already at higher risk of cardiovascular disease, it may still be possible for you to take MHT, but it will depend on your individual circumstances (NICE, 2021).
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The benefits of taking MHT outweigh the risks.