therapy — Hormone replacement therapy can elevate breast cancer risk and may not be an appropriate menopause treatment for all women.

Menopause treatment and breast cancer risk

Published Oct 5, 2017 at 12:00pm

Upon reaching a certain age, women go through the natural process of menopause. This change typically occurs when a woman reaches her late 40s or early 50s.

The transition to menopause happens over
several years and results in fluctuations of
hormone levels in a woman’s body. During this transition, many women experience a variety of symptoms, from mood changes to hot flashes to vaginal dryness. These symptoms can be so severe they impact daily activities and can impede quality of life. Hormone replacement therapy, or HRT, may be prescribed to alleviate the side effects of perimenopause and menopause. However, HRT is not without risks, including an increased chance of developing breast cancer.

According to The Mayo Clinic, HRT, which includes medications containing female hormones to replace the ones the body no longer makes naturally after menopause, used to be a standard treatment for women with severe symptoms. In the largest clinical trial to date, a combination estrogen-progestin pill was found to increase the risk of certain serious conditions, including blood clots, heart disease, stroke, and breast cancer. This type of therapy also may make a woman’s breasts appear more dense on mammograms, making breast cancer more difficult to detect. When undergone for more than a few years, HRT has been confirmed by multiple studies to increase the risk for breast cancer.

Women concerned about HRT and cancer risk, especially those with a significant family history of breast cancer, generally want to avoid the use of hormone therapies. But what is a person who is experiencing many side effects of menopause that can be so easily remedied by hormone therapy to do? Research into HRT alternatives has discovered a host of natural treatments that can provide relief. 


Soy offers some promising results, especially with regard to relieving hot flashes. Soy is very high in phytoestrogens, or plant estrogens. Red clover and flaxseed are other sources of plant estrogens. Phytoestrogens are less potent than pharmaceutical estrogen, and scientists believe they do not contribute to breast cancer in the way natural or pharmaceutical estrogen may.

Black cohosh:

Black cohosh is a member of the buttercup family and is a perennial plant native to North America. Preparations of black cohosh are made from the roots and underground stems. Black cohosh has long been used by natives of North America to treat malaise, gynecological disorders, rheumatism and other conditions. Black cohosh is now sold as an herbal remedy to alleviate hot flashes and excessive sweating in menopausal women. The National Institutes of Health awarded more than $7 million to the University of Illinois to study the efficacy of black cohosh and other herbs in treating certain symptoms of menopause.

Chinese herb dong quai:

This herb is in the celery family and native to Asia. In Chinese medicine, dong quai has been considered a “female ginseng” because of its way of balancing the female hormonal system. As such, dong quai has long been used to relieve the symptoms of premenstrual syndrome and menopause. According to the University of Maryland Medical Center, researchers are unsure if dong quai acts like estrogen or blocks estrogen in the body, as studies have produced mixed results.

Lifestyle changes:

Women may need to dress more lightly, use a water atomizer to spray their bodies to cool down and keep their bedrooms cold to alleviate hot flashes. Vaginal estrogen: If vaginal dryness and pain during intercourse are the primary symptoms, vaginal estrogen rings or suppositories may be necessary. These provide estrogen directly to the affected area while only allowing very low levels to enter the bloodstream. In turn, vaginal estrogen may not increase breast cancer risk in the same way as other hormone therapies.

Hormone replacement therapy can alleviate menopausal symptoms, but also it can elevate breast cancer risk. Other options are available, and women can speak with their doctors about alternatives to HRT.