Developing breast cancer is the top concern among many women, but more than ten times as many women die from cardiovascular disease. Women need to consider their personal risks for osteoporosis and heart disease, in addition to their personal risk for breast cancer, when making decisions about hormone replacement therapy. Health care providers have tools available to assist a woman in determining her risk for breast cancer, osteoporosis, and heart disease. For an average woman at low risk for breast cancer, or one who is at an increased risk for cardiovascular disease or osteoporosis, the small increased risk of breast cancer associated with long- term hormone replacement therapy may be worth it to her. For some women at an increased risk for breast cancer due to advancing age, a strong family history, or pre-malignant biopsies such as those containing lobular carcinoma in situ or atypical hyperplasia, the risks of hormone replacement may outweigh the benefits.
All medications have risks and benefits.
Any woman considering starting, changing, or stopping hormone replacement therapy should sit down with her health care provider and review the pros and cons, as well as other options. The severity of her menopausal symptoms and how they affect her quality of life, her cardiovascular risk factors, her osteoporosis risk factors, and her projected risk for breast cancer should be considered in the decision. A woman should be presented with an assessment of ALL of her risk factors and be counseled appropriately by her health care provider before making or changing decisions about hormone replacement therapy. Founded in 1915, AMWA, a national medical organization of 10,000 women physicians and medical students, is dedicated to promoting women's health and furthering the professional development and well-being of women in medicine. Since the publication of The Estrogen Answer Book some new estrogen products have become available.