Hormone Replacement Therapy and Cholesterol: HRT and Breast Cancer

Posted on February 8, 2011 by Nick in Alternative Therapies

Question: When does a doctor recommend Hormone Replacement Therapy for cholesterol? Does it lower cholesterol? Do newer versions of HRT increase risk of breast cancer? Does the patch or pill provide better protection?

HRT and Cholesterol Levels

According to some studies estrogen replacement decreases LDL and increases HDL both by ten to fifteen percent which is good. HRT after menopause is known to reduce women’s risk of heart disease by half. But it is not the only solution for cholesterol and it is also not recommended for everyone. One can read books by qualified doctors that discuss HRT, review all risk factor and obtain a second opinion; discuss with your respective general practitioner about diet, weight control and exercise.

Newer versions of HRT have placed them in a favorable position. Research shows that estrogen when used alone or in combination with a progestin (synthetic progesterone added to reduce harmful uterine tissue build-up) it does not block the positive effects of estrogen on the lipids. This HRT combination increases and improves HDL levels although in meager amounts. There is an increase of 5mg/dL of HDL if estrogen alone is used. But if progestin is added, there is a rise of approximately of 2mg/dL.

Hormone Replacement Therapy and Breast Cancer

Newer version of HRT formulas will be available that will contain micronized and gentler form of progestin.

These will have a lesser negative impact on estrogen’s positive effects. There are also heart healthy benefits from the HRT, it lowers high Blood Pressure and protects the arteries. But there is an increase in risk of developing breast cancer. But breast cancer cause fewer death than heart disease. So the possible risk of breast cancer is secondary and convincingly negligible, because HRT saves lives of thousands of women from early death from heart disease. Doctors feel that only post-menopausal women with a blood clot or liver disease should be excluded from using HRT.

The oral contraceptive pill lowers cholesterol best, because it is taken by mouth and passes through the liver for metabolism and thereby has a direct effect on the liver function. But skin patch provides estrogen directly through the skin and from there into the blood stream. Although some estrogen may reach the liver its effects are much reduced. Inspire of that, women who use the patch gain some protection from heart disease. The patch is preferred over pill in cases where women have very high triglyceride levels, because oral estrogen can raise triglyceride level.

Risk Factors of Hormone Replacement Therapy

Menopausal women experience a significant decline in hormones and as a consequence lose the benefits that hormones provide. Estrogen for example, is found throughout the body and is implicated in the health of many systems including the reproductive, cardiovascular and urinary tract. Hormones also provide protection for women’s bones. In the absence of adequate estrogen women are more vulnerable to bone loss and perhaps carry a higher risk of hip fractures. In addition Hormone Replacement Therapy (HRT) has been used for years to treat symptoms in menopausal woman such as hot flashes and night sweats. While there are some benefits to HRT there are also some significant risk factors for hormone replacement therapy as well.

A study conducted by The National Institute of Health of the benefits and risk factors for Hormone replacement therapy was halted in 2002 because the risks to participants appeared to outweigh the benefits of continuing the study. Women who were taking an estrogen and progesterone combination showed a greater risk of invasive breast cancer, stroke, and cardiovascular disease. In addition there was an elevated risk of developing blood clots. Women who took estrogen by itself did not show an increased risk for breast cancer or heart disease, but they did have a higher risk of having a stroke. Further, estrogen alone therapy appears to increase the risk of endometrial cancer.

The risk factors for hormone replacement therapy may be minimized somewhat by a few factors. For instance, hormone replacement therapy taken in the early years of menopause may not increase the risk of cardiovascular disease. It is only in women over 60 that this risk factor is significant (Mayo Clinic). Low doses for a short duration may provide relief from menopause symptoms without adding a significant health risk. Women considering beginning HRT should discuss the all of risk factors of hormone replacement with their physicians.

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