HRT (Estrogen and Progesterone Hormone Replacement Therapy) After cancer for menopause?

au0rei
au0rei Member Posts: 252
edited February 27 in Health and wellbeing
Hi ladies,

As the title states, is there any one of you who are menopausal (either due to chemo or ageing) doing HRT/MRT to manage your menopausal symptoms? I am researching into HRT. I had breast cancer in 2016 and these two years entering menopause and the symptoms are awful. The worst are not the hot flushes or night sweats but the irritability, low mood and brain fog that make it very hard for me to function. (There are many more symptoms which I will not list) I have got a family to take care of and that includes not only kids but my elderly parents too.

My research so far has landed on the conclusion that estrogen is so important for normal functioning of our body. I know most breast cancers are estrogen positive but that does not mean estrogen caused the cancer but rather possibly making the cancer grow faster. In fact, my research reveals that the heart, brain, bones and uterus all have estrogen receptors, I guess for proper functioning of these areas, that's why low estrogen means higher risks of osteoporosis, Alzhemier's and heart attacks. No wonder the brain fog! Because of the lack of estrogen.

I am interested in anybody sharing with me your thoughts. And if you are currently doing HRT, where or who can prescribe it.

I know this is a very controversial topic and but I feel that this forum would be a great place to chat about it since most if not all of us have gone through breast cancer.

Thank you xx

#HRT #hormonereplacementtherapy #estrogen #estradiol

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Comments

  • Blossom1961
    Blossom1961 Member Posts: 2,520
    I have three to five hot flushes during the night, every night. Plus numerous during the day. I also have menopause induced issues with my lady bits. Yesterday, my mets nurse put me on to "The Womens Menopause Symptoms After Cancer Clinic" held at the Royal Womens Hospital. I believe there are similar clinics in other states. I need to get a referral and then book in. They have Gynos, Oncos, Endos, Psychs, Sexual Counsellors and specialist nurses in their multidisciplinary team. I am booking in with my GP today to get that referral!
  • June1952
    June1952 Member Posts: 1,935
    I was put on HRT for the rotten menopausal issues following a hysterectomy -  my mother used to tell me I looked like a red Indian !  I stayed on it for 8 months then I decided I did not like taking them.  I did some research and, whilst I hate needles, I went to an acupuncturist and he solved all the menopausal problems.
  • Julez1958
    Julez1958 Member Posts: 1,271
    Hi @au0rei
    Was your cancer ER positive?
    My understanding is that if that is the case any HRT would not be recommended.
    Best to check with an oncologist .
  • au0rei
    au0rei Member Posts: 252
    Julez1958 said:
    Hi @au0rei
    Was your cancer ER positive?
    My understanding is that if that is the case any HRT would not be recommended.
    Best to check with an oncologist .

    Thanks @jul@Julez1958 Mine was ER negative. But even with ER positive cancer, it is not estrogen that causes the cancer, rather estrogen can possibly feed the cancer and causes it to grow faster.
  • cranky_granny
    cranky_granny Member Posts: 918
    Hi @au0rei
    I’ve been warned off any hormone additives i’m estrogen 95% progesterone 90%  with mets. So I don’t want to feed the lesions at all, especially as at last testing I was stable. I tolerate the side effects for the most part. 
    The final choice is always yours to make. You have to be comfortable with your choices not anyone else. 
    I had already gone through menopause by the time I was 40. I hated the thought of getting those symptoms again but I’m okay with my decision to hang in there and take pills 
  • au0rei
    au0rei Member Posts: 252
    Thank you @cranky_granny for your input. It is so sad that the cancer is hormone positive which indeed may feed on female hormones or this is what the medical world believes. At the same time so puzzling as we all grew up with female hormones and our heart, bones, uterus  and possibly brain cells also have estrogen receptors. That is why it is believed when women reach menopause the risks of heat attacks, osteoporosis and Alzheimers’ are greater. In fact more women die from heart attacks than breast cancer after menopause.

    yes the decision is mine but I don’t think there’s any doctors (at least here in Australia) who would be willing to prescribe HRT to a cancer patient. I am just beginning my search on HRT after finding myself menopausal and dealing with awful symptoms. 
  • Keeping_positive1
    Keeping_positive1 Member Posts: 555
    edited April 2023

    @au0rei I can understand the confusion and dilemma regarding estrogen!  I read a lot about foods that are known as phytoestrogens are of benefit to women. 

    Some "experts" say for example, that eating soy products are beneficial, whereas as other "experts" say soy products are to be avoided.  I wonder actually who is right! 

  • Afraser
    Afraser Member Posts: 4,452
    Studies have shown that a woman's risk of breast cancer is related to the estrogen and progesterone made by her ovaries (known as endogenous estrogen and progesterone). As I understand it, estrogen can be produced elsewhere in the body. Post menopause, production of estrogen gradually diminishes. I feel a bit lucky that, if you have to get breast cancer, I got it way past an almost symptom-less menopause, with limited side effects from hormonal therapy (and none of the joint pain/menopausal type). I have no hopes that finally finishing 10 years of hormonal therapy next month will result in some magical improvement in my somewhat battered bone density, but I’ll still be happy. 
  • Keeping_positive1
    Keeping_positive1 Member Posts: 555
    edited April 2023
    .
  • au0rei
    au0rei Member Posts: 252
    Afraser said:
    Studies have shown that a woman's risk of breast cancer is related to the estrogen and progesterone made by her ovaries (known as endogenous estrogen and progesterone). As I understand it, estrogen can be produced elsewhere in the body. Post menopause, production of estrogen gradually diminishes. I feel a bit lucky that, if you have to get breast cancer, I got it way past an almost symptom-less menopause, with limited side effects from hormonal therapy (and none of the joint pain/menopausal type). I have no hopes that finally finishing 10 years of hormonal therapy next month will result in some magical improvement in my somewhat battered bone density, but I’ll still be happy. 

    @Afraser for your input. When you said a woman's risk of breast cancer is related to the estrogen and progesterone made by her ovaries, what sort of relation are you talking about? Making more of such hormones mean increased risk? or decreased risk? Or? What studies were those? I hope you are not referring to the WMI study because it was very warped. I just learnt about it recently. I have not looked at all studies for sure but there is one out of Japan that concludes that frequent miso soup and isoflavone consumption was associated with a reduced risk of breast cancer. I know soy contains phytoestrogen which mimic endogenous estrogen though it is not exactly the same. Here's the study :

    https://academic.oup.com/jnci/article/95/12/906/2520284

    The estrogen hormone is so important in the normal functioning of our body. It is mostly produced by ovaries but at menopause we lose most of it, hence the increased risks of menopausal women getting heart attacks, Alzhemier's and osteoporosis. Risk is heart attack is higher than getting breast cancer apparently. It is also important in mood regulation. The adrenal glands and fat cells can produce a bit of estrogen. I have some joint pain ever since chemo in 2017, that's a side effect, but it is worse now that i have reached menopause. Good to hear that you did not have much menopause symptoms. I have most of the symptoms, the brain fog is the most frustrating! What hormonal therapy are you on? The one to reduce/remove estrogen? Do you get DEXA scan to check bone density?

  • Afraser
    Afraser Member Posts: 4,452
    @au0rei

    I am on Femara, an AI. It helps block oestrogen and I have had regular bone density scans throughout. My bone density was excellent for my age when I started but it has declined, which is partly age too. I think it’s well worth having a scan before you start hormonal therapy, then you know what you have to work with. Or not. Initially I avoided soy products but I suspect there is significant variation in how much people consume and how much is actually likely to trigger anything harmful. Age and other factors weigh in too. Some have advocated avoiding milk products (believing lipids may encourage cancer) while others encourage you to consume them to get more calcium! The problem lies in determining cause as distinct from factors which may simply predispose, given other circumstances. If you didn’t have cancer, it’s fascinating! 
  • au0rei
    au0rei Member Posts: 252
    Afraser said:
    @au0rei

    I am on Femara, an AI. It helps block oestrogen and I have had regular bone density scans throughout. My bone density was excellent for my age when I started but it has declined, which is partly age too. I think it’s well worth having a scan before you start hormonal therapy, then you know what you have to work with. Or not. Initially I avoided soy products but I suspect there is significant variation in how much people consume and how much is actually likely to trigger anything harmful. Age and other factors weigh in too. Some have advocated avoiding milk products (believing lipids may encourage cancer) while others encourage you to consume them to get more calcium! The problem lies in determining cause as distinct from factors which may simply predispose, given other circumstances. If you didn’t have cancer, it’s fascinating! 

    Thank you. What sort of scan are you talking about? Pet? Mammo or US? Yes i totally agree about how conflicting and confusing many things are even among health professionals, all with various convictions about things! That is why we have to do our own research and make the best informed decision about things.
  • Afraser
    Afraser Member Posts: 4,452
    @au0rei

    I was referring to a bone density scan. Your oncologist can refer you - takes about 15 minutes.
    The test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The bones that are most commonly tested are in the spine, hip and sometimes the forearm. 
  • au0rei
    au0rei Member Posts: 252
    Afraser said:
    @au0rei

    I was referring to a bone density scan. Your oncologist can refer you - takes about 15 minutes.
    The test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The bones that are most commonly tested are in the spine, hip and sometimes the forearm. 

    Oh ok yes I just got my Gp to write a referral for me. You mentioned forearm so the Dexa will do the arms too? I am finding my wrists aren’t so good nowadays and I heard wrists are one of the early areas affected by osteoporosis. Thanks @Afraser.

  • KimF
    KimF Member Posts: 44
    Hi @au0rie

    Not sure this is relevant to your initial post! I've been on Letrozole from the day after my diagnosis in mid January 2023 (Er+ Pr+ HER-) - it was the first thing that the oncologist suggested.

    I'm a few years post menopause and had no flushes to speak of - only intense brain fog and lack of energy (blamed on adrenal insufficiency) - debilitating really.

    Roll forward 2 months after taking the Letrozole, the brain fog has lifted and I'm feeling sooooo much better and my energy levels are so much better. I had a DMX a week or two after the fog lifted, and I'm still feeling fine, with no aches or pains. I'm going to start actively trying to reduce my estrogen levels more.

    It's so frustrating that it's not the same for everyone - it would be so much easier it if was!