Breast Cancer and Menopause
The hormonal changes that happen during the menopause can have a dramatic impact on your body. Learning about the connections between your hormones and breast cancer can help you to understand your breast cancer risk and enable you to make the right choices about treatments like HRT.
Breast Cancer Risk and the Menopause
The risk of breast cancer increases with age, but there is no suggestion that this is directly because of the menopause. Breast cancer if you started menstruating early (before the age of 12) or if you start the menopause late (after the age of 55) possibly because you will have been exposed to more of these hormones over your lifetime.
Using hormonal contraceptives that contain hormones such as oestrogen and progesterone could also have a small effect on your cancer risk. There is some evidence that long-term use of hormonal contraceptives could slightly increase the risk of breast cancer but using these types of contraception can also help to protect you against ovarian cancer. Most women can take hormonal contraceptives safely, but you should discuss the risks and benefits with your doctor. You might decide to choose a different type of contraception if you are already at higher risk of breast cancer due to your family or medical history.
Breast Cancer Treatment and Menopausal Symptoms
Some kinds of breast cancer treatment such as hormone therapy, ovarian suppression and chemotherapy can affect the levels of the hormones that control the menstrual cycle. The menopause is triggered by a decrease in the production of these hormones, so treatments that cause similar drops in hormone levels can lead to the same kinds of symptoms. Sometimes the effects are only temporary, so you may experience some menopause-like symptoms during treatment. However, breast cancer treatment can sometimes trigger the menopause and cause permanent changes.
Some women who have the BRCA1 or BRCA2 genes that are associated with both breast and ovarian cancer may decide to have preventative surgery to remove their ovaries, which will lead to menopause.
Breast Cancer and HRT
Hormone Replacement Therapy (HRT) is very effective in relieving symptoms that some women experience during the menopause. The standard recommendation has been that HRT is not recommended for women who have a history of breast cancer. Recent data suggest that in women who have had a hysterectomy taking oestrogen-only HRT slightly reduces the risk of breast cancer. Those women who have intact uterus are usually given oestrogen and progesterone and they seem to have a slightly higher risk of developing breast cancer. The absolute impact of HRT on your breast cancer risk is fairly small, so if your menopausal symptoms are very severe you might want to discuss the risks and benefits of HRT with your doctor so a balanced judgment about taking HRT can be made. You can also get advice on other ways of managing your symptoms.