Q. I took bio-identical hormone replacement therapy (BHRT) to handle my horrible hot flashes. After taking it for three months, I started having pains in my breasts. A mammogram did not show any problems, but the recommendation was made that I stop taking the compounded HRT. The pain went away when I did so.
I did feel better while on BHRT. My doctor told me, though, that even compounded bio-identical HRT still counts as hormone treatment. Any thoughts?
A. For more than 50 years, physicians prescribed traditional hormone replacement therapy (HRT) for menopausal symptoms with the expectation that it would protect the cardiovascular system and the bones as well. The Women’s Health Initiative (WHI) in 2002 revealed that HRT could increase the risk for heart attacks, strokes and breast cancer.
Bio-identical hormone therapy has not been subjected to the same careful scrutiny as the WHI, so its long-term safety is still a question. We believe that, in your case, stopping the BHRT was smart. Data from the WHI show that women who experienced breast pain or tenderness while taking HRT were at substantially higher risk for invasive breast cancer (Archives of Internal Medicine, October 12, 2009).
In general, women having a difficult time with menopausal symptoms are urged to use the lowest effective dose of hormones for the shortest time that they are needed. For more information on hormone pros and cons and other ways to deal with hot flashes, we offer our Guide to Menopause.
