• Thu, Jul 2 2009

If It Is ‘The Change,’ I’m Not Touching HRT

My birthday is looming. I’ve never been concerned about my age, but I’ve never been this old before. I still picture myself as a 27-year-old woman and yet, I am so far removed from that age group it is depressing.

pillsI was driving home from my friend Linda’s house (by the way, she is older than me) in this 90-degree heat with my air on 70 (because I don’t like to freeze, especially in summer), when I felt my seat warmer come on. What was so strange about it is that my seat only warms from the seat area, not the back, and that’s where I was feeling the heat. I checked the dial on the dashboard but the knob read 0. Strange. I reached around and felt the seat and it wasn’t hot to the touch. Then I realized the heat I feeling was radiating from the inside of my body, starting from my back and wrapping around my torso, causing me to shake and sweat – and I’m not talking a damp brow, but a sweat that drenched my scalp and clothes before I even pulled into my driveway.

I’ve been blogging about menopause and the risks of hormone replacement therapy (HRT) for the law firm long enough to know that my symptoms were frightfully similar to that of a hot flash. But I can’t imagine that I’m old enough to be going through “the change.” A little symptom Googling and I surmised that it could likely have been a low blood sugar issue. My nurse practitioner friend Kathy said it was possible, but more likely I experienced a hot flash. I described a text book case. She said if my mother went through perimenopause at an early age, I likely could as well.

I can’t ask my mother because she’s dead. And thanks to my regular blogging with the law firm, I now am convinced her HRT killed her.

One most often hears of the connection between HRT and breast cancer. In 1991, the Department of Health and Human Services, the National Institutes of Health, and the National Heart, Lung and Blood Institute launched the Women’s Health Initiative (WHI), a 15-year research program to address the most common causes of death, disability and poor quality of life in postmenopausal women – cardiovascular disease, cancer and osteoporosis. WHI consisted of a hormone trial and that is where researchers began to see an alarming trend –women on HRT were at an increased risk of serious health complications, most notably, breast cancer. The link between HRT and breast cancer has spurred numerous lawsuits against the makers of the one-time wildly popular Premarin and Prempro. People don’t hear so much about the uterine cancer risk because it’s a little different.

You can look up the connection between HRT and uterine cancer (also known as endometrial cancer) at the American Cancer Society or the National Institutes of Health and they’ll tell you the same thing – that the risk for endometrial cancer (this affects women who still have their uterus) is more than five times higher in women who take estrogen-only therapy (ERT) compared to estrogen plus progestin (HRT). Thus, women who no longer have a uterus are often prescribed ERT and women with a uterus are given HRT, which does not carry the same risk of endometrial cancer.

Years ago when my mother sat down with her general practitioner and requested help overcoming her symptoms of menopause, her GP gave her a choice – one pill would keep her menstruating, the other would not. She made the obvious choice. Perhaps the GP was unaware of the increased risk of uterine cancer with ERT. Maybe researchers were still combing the data. But the fact remains, my mother was diagnosed with uterine cancer. The next three years involved painful surgeries and procedures. The last six months were of excruciating pain.

My OB/GYN dismisses this connection. He says estrogen-receptor positive cancers are usually less aggressive and easier to treat. Sure, some studies show uterine cancer has an 84.4 percent survival rate. That hardly matters when you fall in the 15.6 range.

If it was a hot flash I experienced and I am embarking on my path down the shady road of perimenopause, I will not choose to take HRT. The risks are just not worth it to me. If the symptoms get worse – and I hear they often do – I will seek out holistic methods, acupuncture, yoga or whatever. And I will pray never to suffer like my mother had to.

Photo, Flikr, erix

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  • http://www.blisstree.com Michelle Smith

    My mom and I were talking about HRT the other day. I am 42, 43 next month. I told Mom that I am not taking hormones after she told me that she suspected that my fatigue and sore joints were related to hormones. She appears to think that my intention to avoid HRT is ridiculous. My fear is breast cancer.

    I’m sorry about your Mom. I”m very sorry that she suffered.