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Estrogen vs. Estrogen-Progestin: Which Hormone Therapy is Safer?
Published: Feb 05, 2024
Not all hormone therapies are created equal when it comes to breast cancer risk. This article compares estrogen-only therapy with combined estrogen-progestin therapy, revealing important differences in their safety profiles.
Estrogen-Only Therapy: The Surprising Findings
Contrary to what many might expect, estrogen-only therapy hasn't been linked to increased breast cancer risk in short-term use. The Women's Health Initiative (WHI) study found that women using estrogen alone for an average of 5.9 years actually had a slightly lower risk of breast cancer. This is reassuring news for women who've had a hysterectomy and are considering estrogen therapy for menopause symptoms.
Combined Therapy: A Different Story
Combined estrogen-progestin therapy, however, does increase breast cancer risk. The WHI study found that women using this therapy had about 8 extra cases of breast cancer per 10,000 person-years of use. The risk became apparent after about 3-4 years of use. This difference highlights the important role that progestins play in breast cancer risk.
The Progestin Factor
The addition of progestin to estrogen therapy seems to be the key factor in increased breast cancer risk. Some studies suggest that different types of progestins may have different risk profiles. For example, natural progesterone might have a lower risk than synthetic progestins, though more research is needed. The way progestin is given (continuously or cyclically) may also affect risk, but findings are inconsistent.
Frequently Asked Questions
To protect the uterus from estrogen-related cancer risk.
No, it's typically only for women without a uterus.
Some non-hormonal options exist; discuss with your doctor.
Possibly, but more research is needed on different types.
Consider your individual health profile and risk factors.
The Key Takeaway
While estrogen-only therapy appears safer regarding breast cancer risk, the choice between therapies depends on individual health factors and needs.
References
- Manson JE, et al. JAMA 2013; 310:1353.
- Chlebowski RT, et al. JAMA Oncol 2015; 1:296.
- Fournier A, et al. Breast Cancer Res Treat 2008; 107:103.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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