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Category: Women’s Health

Black Women’s Conference
BlogWomen's Health

Black Women’s Conference

Last weekend, we attended the Black Women’s Conference. This is an annual event organised by The Black Women’s Forum that  aims to provide a safe space to share, empower and engage with women of African,  Asian, Arab and Caribbean descent living in the UK. It provides a forum for open, honest discussion on issues affecting black women.

This year’s conference was the fifth anniversary of the event and the theme of the conference was ‘Celebrating the Achievements of Women of Colour.’ The  program included panel discussions in the morning followed by workshops in the afternoon.

The panel discussions consisted of speakers from a variety of fields with the first panel focusing on black women in the creative and education industry and the second panel focused on black women in sports and business.  You can find out about all the speakers here

We were really inspired by all the speakers who took part in the panel discussions  and it was interesting to note that the message of the importance of our health and wellbeing was a theme that recurred in almost every presentation.

Black women in the business world face a lot of barriers and challenges which were clearly illustrated by the speakers as they shared their stories of racism and sexism. This core barrier of racism has led to loss of opportunity, difficulties in securing investment, daily battles with “the system”, lack of career progression and so much more.  Fighting these inequalities every single day is tough, affects our wellbeing and can thus impact both our physical and mental health.

We applaud the honesty of Imriel Morgan, the Chief Executive of the Shout Out Network and co-host of Melanin Millennials who spoke with passion about the pioneering work that she’s doing in the podcasting world and the challenges she has faced. This has included difficulties getting her podcast onto well-known platforms which lack diversity and seem not to embrace black podcasts and organising the first ever black podcasting festival. Imriel spoke of the frustrations of not being able to access investment despite being an award-winning podcast and then very movingly tried to fight back tears as she told us that being a black female Chief Executive is really tough. Imriel opened up and was very honest about her experience with depression saying “the struggle is real” and spoke about being on anti-depressants.

We have to do something about this. We have to make sure that black business women have all the support that they need to fight these battles and get through them with their physical and mental health intact. One solution that was discussed throughout the day was the need for black women to come together to form supportive networks so that women have a support system and don’t feel alone in the corporate world.

We feel there is much to do in this area and will explore what we can do as a charity to support black business women.

A Summary of This Week’s Fibroids Twitter Chat with Dr Sydney Dillard
BlogFibroids Twitter Chats

A Summary of This Week’s Fibroids Twitter Chat with Dr Sydney Dillard

On Wednesday,  we were so excited to host our third fibroids Twitter chat. We were joined by special guest Dr Sydney Dillard, CEO of Fighting Fibroids to discuss the symptoms and diagnosis of fibroids.  If you missed it you can check out our conversation below.

APPG Publishes Report on Fibroids and Informed Choice
BlogFibroidsWomen's Health

APPG Publishes Report on Fibroids and Informed Choice

We were so delighted when we received an email from the All-Party Parliamentary Group on Women’s Health a few months ago telling us that they would be carrying out an inquiry into informed choice and fibroids and endometriosis,  two of the most common conditions affecting women.

The aim of the inquiry was to explore whether women with fibroids and endometriosis are given an informed choice about the treatment options available and to outline what improvements need to be made.

In order to assess this issue the APPG on Women’s Health consulted with women affected by these conditions as well as healthcare professionals. This was done through a survey, written evidence submissions, an oral evidence session and freedom of information requests to all 139 hospital trusts in the UK.

The Lake Foundation started working on providing information and support to women with fibroids about two years ago following our own survey which found that more needed to be done to ensure women had enough information and support to manage their condition. We published a fibroids booklet, formed an Ask the Expert panel and hosted our first fibroids conference for women affected by fibroids. So for us the APPG’s inquiry was a breath of fresh air as it finally put a national spotlight on fibroids and in doing so enabled the challenges that women with fibroids experience to be raised at the highest level possible, in parliament, and we hope that this will bring about real change.

Results from the Inquiry

The inquiry has now come to an end and this week the APPG on Women’s Health published their report and, like the results of our survey, their report makes for grim reading. Nothing has changed.

Over 2,600 women with fibroids (237) and endometriosis (2,367) completed their survey and:

  • 62% said they were not happy with the treatment choices
  • 42% said they were not treated with dignity and respect
  • 67% said they first found information about their condition from the internet

Looking at just the answers that related to fibroids, 70% of women were told about a hysterectomy suggesting that women are pushed towards this treatment option when many other options are available.  Over 20% of women with fibroids felt the need to get a second opinion and 34% of women were not satisfied with their treatment.

Additionally, over 40% of women with fibroid were not told about the short-term complications of their treatment and over 50% weren’t told about the long-term complications.

The inquiry also identified a number of barriers that prevent women from receiving the best care possible. These included:

  • Lack of public awareness
  • Lack of understanding of these conditions by GPs
  • Common myths about fibroids and endometriosis
  • Lack of information
  • An inefficient diagnosis pathway
  • Lack of follow-up and support after treatment

As a result of their inquiry the APPG made a number of recommendations which fell into the following categories

  • Improve patient experience
  • Improve awareness
  • Improve the diagnosis pathway

Our Thoughts

The Lake Foundation was happy to see this inquiry take place and happy to see the report published. We were disappointed that, even though we raised it, there was no recognition of the fact that fibroids are more common in black women and black women are more likely to develop multiple and more aggressive fibroids. This is an important point to highlight as it means that there needs to be a greater focus on black women who will need more support. GPs need to be aware of this so they can diagnose black women quickly and look at treatment stratgies before symptoms become unbearable.

More Information

For more information you can read the APPG’s full report below.

Did you miss our fibroids Twitter chat with Dr Sydney Dillard and Renee Brown Small?
BlogFibroids Twitter Chats

Did you miss our fibroids Twitter chat with Dr Sydney Dillard and Renee Brown Small?

Last night, we were so excited to host our first fibroids Twitter chat. We were joined by special guests Dr Sydney Dillard, CEO of Fighting Fibroids and Renee Brown Small Co-founder of The Fibroids Project with host, our own Abi Begho, founder of The Lake Foundation.

If you missed our Twitter chat you can check out our conversation below and look out for our next Twitter chat on Wednesday 15th February at 7pm (UK time).

Update June 2018: Please note that tweets from Renee Brown Small are no longer available so some information is missing from the chat below.

In the media this week: Breast cancer is more likely to be diagnosed at a late stage in black women
BlogCancerWomen's Health

In the media this week: Breast cancer is more likely to be diagnosed at a late stage in black women

Today, Cancer Research UK and Public Health England announced that a recent analysis of cancer data revealed that black women are twice as likely to be diagnosed with late stage breast cancer as their white counterparts. They found that 25% of black African breast cancer patients and 22% of black Caribbean patients had late stage disease compared to 13% of white patients.

The fact that black women are more likely to be diagnosed at a late stage has been known for some time and has also been observed in not just the UK but in the USA too. The Lake Foundation has conducted work in this area to explore the possible reasons behind this. In 2011, we carried out some qualitative research to explore black women’s beliefs about breast cancer and their help-seeking behaviour to determine whether these two factors may lead to delays in diagnosis. Overall our study suggested that, when it comes to seeking help, black women are quite proactive and there would be no delay in visiting their GP (doctor) if they noticed a breast lump; delays in visiting a GP could occur if black women experience other symptoms as they were less aware of these.

We also found that the following factors could delay help seeking in black women: other priorities such as family or work commitments; language barriers; lack of access to information; age (older people are more likely to delay visiting their GP); difficulty getting appointments; cultural insensitivy of the healthcare system, inaction by GPs; and a lengthy referral process. You can read more about this work on our research page (scroll to the bottom of the page).

National data suggests that black women are less likely to take part in the NHS Breast Screening Programme and this could be another reason for the late stage diagnosis. In 2011, our founder Abi Begho worked with Betterdays Cancer Care, the NHS and Cancer Black Care to determine why black women are less likely to attend breast screening and whether patient navigation could be an effective way of improving screening uptake in black women in Peckham and Lewisham. We found that, at the time, black women living in Lewisham and Peckham who were of screening (over the age of 50) were very mobile with many women being unreachable, on an extended trip abroad; having moved from their GP registered address or had relocated and lived abroad,  hence they missed their breast screening appointments. We found that patient navigation was effective at reaching women as numerous and extensive attempts were made to contact women and then support them to attend their screening appointments. You can read more about this work here

Finally, scientific research has also suggested that black women are more likely to develop a more aggressive form of breast cancer which grows rapidly, so this could explain some of the late stage cases. Studies also suggest that black women are more likely to develop breast cancer at a younger age.

This recent analysis by Cancer Research UK has reminded the nation that there is an issue around black women and breast cancer that needs to be addressed. We need to ensure that black women are aware of all the signs and symptoms of breast cancer and that they seek help quickly if they notice any of the symptoms. We also need to understand the biology of the disease and the best ways of detecting and treating the more aggressive forms of breast cancer.

So, the message to black women is:

  • Be aware of all the signs and symptoms of breast cancer
  • If you’re worried about any symptoms that you have, please visit your doctor as soon as possible
  • Eat a healthy diet, keep active and maintain a healthy weight to reduce your risk of developing breast cancer
  • If you’re aged 50 or over, consider accepting your invitation from the NHS to take part in breast screening
  • Know your family history. If you have a strong family history of breast cancer you may be at an increased risk so visit your GP for some advice and information
Fibroid Forum Part 2: Treatment
BlogFibroids

Fibroid Forum Part 2: Treatment

On 1st October, we attended the Fibroid Forum. This was an excellent informative event organised by a group of ladies affected by fibroids.  In our previous blog we discussed the first half of the event and in today’s blog we’ll summarise the second half of the event.

The final part of the fibroid forum focused on treatment and we heard from two speakers on this topic, Dr Raj Das, Consultant Diagnostic and Interventional Radiologist at St Georges and Professor Isaac Manyonda, Consultant Obstetrician and Gynaecologist at St Georges.

Uterine Artery Embolisation

fibroidforumdas

Dr Raj Das focused his presentation on uterine artery embolisation (UAE), an established procedure which has been used by doctors since the 1990s to treat fibroids; it involves cutting off the blood supply feeding the fibroid.  Dr Das spoke about the evidence that demonstrated the benefits of UAE. The benefits include patients having a good clinical outcome, patients reporting a good outcome themselves, lower blood loss, a shorter hospital stay and a quicker return to work than  some other procedures.  He also added that for UAE the rate of infection is less than 5% and that after the UAE procedure the fibroids are still there and what they are looking for is symptom improvement rather than disappearance of the fibroids, but in 3-5% of cases the fibroids do clear themselves. He stated that UAE is a viable treatment for those wishing to retain fertility.

Dr Das also mentioned that UAE can be used when women with fibroids have any of the following: severe heavy bleeding,  painful periods, anaemia and pressure on the bladder or bowel.  He also touched on aftercare and suggested that women take 1-2 weeks off work after the procedure, avoid driving for five days and only engage in light activities at home during the recovery period.

Surgical and Medical Treatment

Following Dr Das’ presentation we then heard from Prof Isaac Manyonda. Prof Manyonda discussed surgical and medical interventions for treating fibroids and started by explaining that it is very important that doctors optimise the care that women receive because of the changing demographics of childbirth – women are delaying pregnancy until later in life when fibroids are more common and more likely to be symptomatic.  He said the old adage “babies, then fibroids, then hysterectomy” no longer works.

Fibroids Forum Manyonda

 Prof Manyonda focused his talk on two areas:

  • The surgical removal (myomectomy and hysterectomy)
  • The medical management (drug treatment – ESMYA)

With regards to surgical removal, Prof Manyonda stated that a myomectomy is more complex than a hysterectomy (removal of the womb) and there can be more blood loss. He mentioned that for the same sized fibroid it takes 40 minutes to perform a hysterectomy compared to  sometimes 150 minutes for a myomectomy. He also described the benefits of a hysterectomy which are: it provides a definitive cure, there is no possibility of a recurrence of the fibroids and it has one of the best outcomes  in terms of quality of life, but it does remove all fertility potential.  Prof Manyonda talked about the recovery period saying that a hysterectomy requires a 3-4 night hospital stay and an 8 week recuperation period with a phased return to work.

Prof Manyonda then discussed a myomectomy which is the removal of the fibroids while preserving the womb so there is the possibility of pregnancy in the future.  He explained that it requires a 4 night hospital stay and, like a hysterectomy, women will need an 8 week recuperation period with a phased return to work.  He also advised that women wait 6 months before attempting pregnancy. He did warn that whilst one of the main benefits of a myomectomy is to preserve fertility it can actually compromise the very same fertility that it is intended to preserve due to the formation of scar tissue, so it needs to be done carefully. Furthermore he explained that with a myomectomy we’re dealing with the fibroids that are there and it doesn’t tackle the cause so new fibroids can develop. He also said that it’s best that all the fibroids are removed and none are left behind to give women the best chance of a good outcome long-term.

He mentioned that many women are only offered a hysterectomy because it is felt they are too old for child-bearing or their fibroids are too large, too many or in the wrong place, but research has shown that women should also be offered a myomectomy and age, size, number nor location of fibroids should be a barrier.

Finally Prof Manyonda touched on the medical management of fibroids with the drug ESMYA. He stated that we need as many weapons as possible to fight fibroids as not everyone is suited for surgery or UAE. ESMYA is a drug that initially was licensed to be used 3 months prior to surgery but now it can be used as a standalone therapy. Research has shown that it can reduce the size of fibroids and improve a number of fibroids-related symptoms. He said whilst it is promising we have to exercise caution as its unclear what the long-term impact of this treatment will be. He said ESMYA is a good option for older women or for those who are not keen on surgery.

This was a really informative event which ended with an open discussion where women were able to ask Prof Manyonda and Dr Das questions and share their personal stories.

We’d like to thank the House of Bread for organising this much-needed conference and we were very pleased to have been given the opportunity to have a stall at this event.

Fibroid Forum Part 1: Introduction, Personal Stories and NICE Guidance
BlogFibroids

Fibroid Forum Part 1: Introduction, Personal Stories and NICE Guidance

Last Saturday, we had the pleasure of having a stand at the Fibroid Forum. This was an event organised by a group of ladies from the House of Bread who have all been affected by fibroids.

The event brought together clinical experts, organisations working on various aspects of fibroids and women affected fibroids  to discuss this health issue and its treatment. There was also an open forum with an expert panel giving women the opportunity to share their experiences and ask experts questions.

In this blog we’re going to summarise the first half of the event which covered an introduction to fibroids, personal stories and an overview of the NICE guidance.  In our next blog we’ll summarise the second half of the event which covered surgical treatment, radiology treatment, aftercare and the open forum.

An Introduction to Fibroids

audrey

The event started with a welcome and opening prayer by Dawn Martin who also shared her story and stressed that fibroids are not just physical but emotional and it’s something that affected every aspect of her life including her relationships, work, what she wore and even planning her holidays.

This was followed by a short film that provided an overview of what fibroids are and then we heard from our first main speaker, Audrey Skervin, who talked through some facts and figures  as well as the symptoms.

We then heard from Yvonne Maye who discussed how fibroids have affected her. She stated that she was happy that we’ve now reached an age where women can speak openly about fibroids as when she was diagnosed many years ago issues like fibroids were not spoken about meaning that many women suffered in silence. Another interesting point she raised was the pressure that women felt at the point of diagnosis to have baby. Many doctors, and this was confirmed by other attendees, placed women under a lot of pressure to start having a family without understanding their personal situation and this added to their distress.

Fibroids Research Update: New NICE Guidelines on Heavy Bleeding

christine

Next on the agenda was Christine Clewlow, Medical Scientific Liaison Manager at Gedeon Richter. She gave an update on interesting fibroids news focusing on the NICE guidelines.

NICE or the National Institute of Health and Care Excellence is the organisation that produces evidence-based guidance that is used by the NHS to decide what treatment should be made freely available on the NHS.

NICE has guidance on heavy menstrual bleeding which is very relevant to many women affected by fibroids, as this is one of the main symptoms. The NICE guidance on heavy bleeding was first written in 2007 and a summary version is available here. The parts of the guidance that are relevant to patients are:

  • Any interventions [to treat heavy menstrual bleeding] should aim to improve quality of life measures
  • A women with heavy menstrual bleeding referred to specialist care should be given information before her outpatient appointment
  • Ultrasound is the first-line diagnostic tool for identifying structural abnormalities (e.g. fibroids)
  • A women with heavy menstrual bleeding should be given the opportunity to review and agree any treatment decisions. She should have adequate time and support from healthcare professionals in the decision-making process

Christine highlighted the importance of these guidance  stating that they are designed to ensure that patients are being treated appropriately and women shouldn’t be afraid to challenge doctors if they aren’t following the guidance.

Christine also informed attendees that the guidance is being updated and the new guidance should be published in August 2017

In the discussion following Christine’s presentations there were some really useful recommendations put forward for women who have symptoms they are concerned about:

  1. Before visiting your GP make a list of all your symptoms
  2. Do your research so you arrive at your appointment with your GP prepared
  3. Make a note of all your questions so you can have a constructive discussion with your GP
  4. If you think you may have fibroids, be aware of the guidance so you can have an informed discussion with your GP about next steps.

This ended the first half of the event which was a good introduction into fibroids, providing attendees with a good foundation for the next half which was more clinical and this will be covered in our next blog. Stay tuned!

Have an Organic Time of the Month
BlogWomen's Health

Have an Organic Time of the Month

This blog is the second in a two-part series discussing alternative feminine hygiene products. This follows on from our blog on menstrual cups and this series is a result of a discussion at our recent fibroid focus conference that got us thinking about the fact that many women with fibroids experience heavy and prolonged periods. This means they use large quantities of tampons and pads and we want to ensure that women who use these products more frequently than most are aware of all the options out there so they use the best products for them.

What’s the Problem?

Over the last few years there has been quite a bit of focus on the chemicals in feminine hygiene products and these chemicals have raised concerns about their possible health effects.

Research has shown that chemicals like dioxins are found in trace amounts in tampons and pads. These chemicals are by-products of the bleaching process and whilst they are in small quantities and cause no harm after just a one-off exposure, women use these products very frequently and it’s not clear if the frequent exposure could lead to an accumulation of dioxins in the body. The WHO states that long-term exposure to dioxins  is “linked to impairment of the immune system, the developing nervous system, the endocrine system and reproductive functions.”

Additionally, testing has found detectable amounts of pesticides in five out of eleven of the products tested and long-term exposure to pesticides may affect the liver, brain and reproductive system and has been linked to autism and some types of cancer.

Furthermore many manufacturers don’t list all the chemicals in their products making it hard for women to make an informed choice about the products they use. This led to a petition calling for companies to list all the components of their feminine hygiene products which has been signed by over 250,000 people.

The Solution

In order to avoid the chemicals in tampons and pads a number of companies now manufacture organic feminine hygiene products to give women a more natural alternative.

Companies producing organic feminine hygiene products tend to used certified organic cotton as their absorbent material rather than synthetic absorbent material. They also don’t use harsh bleaching agents so their products are chlorine free and won’t have traces of dioxins.  They are also plastic free, fragrance free and many consider the environment and make their products biodegradable.

These organic products are a good alternative to the synthetic products that are widely available and it is worth searching them out.

Where Can I get Organic Feminine Hygiene Products?

One of the most well-known manufacturers of organic tampons and pads is Natracare, they have been producing these products for almost 30 years and have a wealth of experience. Their products are plastic free, certified organic, animal friendly, don’t result in fibre loss and are recommended by gynaecologists.  To find out where you can purchase their products click here.

Other organic feminine hygiene products include:

For a convenient one-stop-shop that sells a few different brands, then you can try Be Prepared.Period who sell a range of organic feminine hygiene products.

Be Prepared. Period.

If you’re looking for a more natural alternative when it comes to tampons and pads then why not give the  above mentioned organic products a try.

Do you use any of these products? What are your thoughts? We’d be interested in hearing what you think about this topic. Is using organic feminine hygiene products important to you? Leave a comment below.


References

A question for women’s health: chemicals in feminine hygiene products and personal lubricants. Environ Health Perspect. 2014 Mar; 122(3): A70-5.

Feminine Protection Products: What do they consist of? 60 Million Consumers, 23rd Feb 2016

Tampax tampons and Always sanitary towels among feminine hygience products that contact toxic chemicals.  The Independent, 25th Feb 2016.

My Journey with fibroids, endometriosis and more…
BlogFibroidsMy Fibroid StoryWomen's Health

My Journey with fibroids, endometriosis and more…

Many years ago before I even knew what endometriosis or fibroids were I knew the sudden stabbing pains I felt in my side weren’t right. My periods were often heavy and ‘clotty’ but I was too embarrassed to discuss it with anyone and so I suffered in silence.

Some years later I was living in England and when the pain recurred I went to see my GP who disappointed and shocked me with his response when I described my symptoms to him. My GP asked me whether I was planning to have children. I was 22 then and not ready. He replied, ‘well there are a lot of people who don’t have children’. I left the clinic stunned. I wasn’t very assertive then so didn’t answer him back.

Fortunately, I did have my son a couple of years later and all was well. I remember though that the pains would come and go but I just bore it. During a trip to Ghana, I woke up to stabbing pains in my right side again which had me doubled up in pain. When I got back home I saw my GP who referred me to a Consultant who happened to be the one to travel this journey with me. She sent me to carry out some tests which revealed I had endometriosis and fibroids. I was given tablets to help and the pain subsided. By then my son was 5/6 years old. At one of my check-ups my Consultant asked me whether I wanted any more children and advised me to do it ‘sooner rather than later’.

Endometriosis

A year later, on Valentine’s Day, I went for another check-up, my Consultant was about to prescribe some more medication for me when I told her I might be pregnant. We did a test which was positive!

Whilst pregnant and after my daughter’s birth there were no symptoms and my doctor told me many women find the fibroids and endometriosis disappear during pregnancy.

Eight years ago I felt the pains and discomfort again. The same Consultant I had seen over 12 years earlier was still working at the hospital which I considered a blessing as she knew my history. She sent me off for a scan. I knew there was a problem when the lady carrying out the scan stopped joking and suddenly had a serious look on her face. I asked whether everything was alright, she told me my Consultant would be in touch.

I received an appointment. It was a different Consultant this time who asked me to have some blood tests done. I asked him whether I should have them done at my local hospital, he said no and that I had to have the blood tests done straight away!! As I walked to the department to have the tests done I opened the letter and saw the letter C scribbled amongst other medical jargon. I knew straight away I was being sent to test for some form of cancer. And I was on my own!

I got home and looked the medical term up on the internet which confirmed my fears, it was a test for cancer!

Another appointment came and my husband accompanied me. Thankfully it was my regular Consultant. She gave me the results and explained the scan showed a very large cyst on my right ovary which they thought could have been cancerous. The blood tests had however come back clear.

cyst

Ovarian Cyst

My Consultant went on to say she felt I needed to have a hysterectomy as soon as possible because I had a ‘diseased womb’. My husband and I were shocked and we tried to ask for other options. She told us that this time I didn’t have a choice and that on top of my problems with fibroids, endometriosis and the cyst on my ovary I also had an ‘enlarged womb’! Gosh, the list just gets bigger! She then booked an appointment whilst we were in her office for my surgery in 2 weeks’ time!

I had the surgery by this Consultant in September 2006 and thank God all was well. No cancer found. I however had to undergo a ‘total hysterectomy’ which meant losing my ovaries, womb, tubes and cervix. I guess the risk of cancer was great and she wanted to eliminate any possibility.

I cried for a while to think I had lost my ‘womanly bits’ but my husband sternly told me to be grateful to be well and alive. That shook me up and I started to take a positive approach. I had two healthy children, one of whom I didn’t think I would be able to have. I used to call her my ‘little miracle’.

After my surgery I had to go on HRT which I didn’t want to because it made me ‘feel old’. I soon went on it though when I had a sudden surge of heat through my body and quickly stuck my head in the freezer! My family watched me do this in amazement, confusion and amusement!

I have been on HRT patches for 8 years now and feel fine. I have put on a lot of weight but I’m not sure whether that has anything to do with the HRT or the lovely cakes people keep bringing in to work!!

Two months ago a friend mentioned HRT caused her to put on a lot of weight. She came off it and used another form of medication which is made from natural minerals. I have started using it too and have taken myself off the HRT. I have weighed myself and found I have lost a little weight. I need to cut out the cakes and do some walking and I will be back in shape.

I am thankful for my life and have learned it is good to talk, share our fears and experiences; you can learn from someone else and they can learn from you! Let’s be aware and educate ourselves.

Well done on setting up this website!


The Lake Foundation would like to say a big thank you to Naa for sharing her experience with fibroids and endometriosis, we hope that through her experience you have gained some insight into these conditions.

To learn more about fibroids download our booklet below  and for more information about endometriosis visit Endometriosis UK’s website

Be Prepared. Period.

Disclosure: this post contains an affiliate link. Find out more here.

The Effect of Combined HRT on a Women’s Risk of Developing Breast Cancer May Have Been Underestimated
BlogCancerWomen's Health

The Effect of Combined HRT on a Women’s Risk of Developing Breast Cancer May Have Been Underestimated

A study published in the British Journal of Cancer has found that the effect of combined hormone replacement therapy (HRT) in increasing a women’s risk of developing breast cancer is likely to have been underestimated in previous studies.

HRT is used to treat the symptoms of menopause (hot flushes, mood changes etc) by replacing the oestrogen that is lost during a woman’s menopause. There are two type of HRT, oestrogen only HRT and combined HRT which is mixture of oestrogen and progestogen.

Over the years studies have identified that women using HRT have an increased risk of developing breast cancer but this was only felt to be a slight increase with many stating that the benefits of taking HRT outweigh the risks.  This new study has found that combined HRT actually has a bigger effect on breast cancer risk than was previously thought.

This New Study

This new  piece of work was part of the Breast Cancer Now Generations Study which was set up in 2004 to understand the causes of breast cancer. The full Generations Study is following 113,000 women in the UK for 40 years.

 For this research into the effect of HRT, 39183 women from the Generations Study were selected who were at menopausal age. These women had  been monitored for 6 years through questionnaires which asked a number of questions including questions about their HRT use.

After the six years of monitoring it was found that 775 of the 39,183 women had developed breast cancer. Statistical analysis revealed that women using combined HRT were 2.7 times more likely to develop breast cancer than those who had not used HRT. This applied to use of HRT for a median length of time of 5.4 years and when they explored longer use of HRT, so 15+ years of use, this increased to women being 3.27 times more likely to develop breast cancer. No overall increase in breast cancer risk was observed in women who used oestrogen only HRT.

They also found that the increase in risk returns to almost normal once combined HRT use is stopped. Researchers noted that after a year and also two years of ceasing to take combined HRT there was no significant increase in breast cancer risk.

How Did Other Studies  Result in an Underestimation of Risk?

The underestimation by previous studies occurred because of the way the studies were carried out. Previous studies didn’t comprehensively follow-up with women and document their use of HRT  (e.g. did some women  stop using HRT over the course of the research) nor did they determine the age at which women went through the menopause.  These oversights caused inaccuracies.

What Does this Mean for Women Considering Taking Combined HRT?

Baroness Delyth Morgan, the Chief Executive of Breast Cancer Now said:

“Whether to use HRT is an entirely personal choice, which is why it’s so important that women fully understand the risks and benefits and discuss them with their GP. We hope these findings will help anyone considering the treatment to make an even more informed decision.

“On balance, some women will feel HRT to be a necessity. But in order to minimise the risk of breast cancer during treatment, it is recommended that the lowest effective dose is used for the shortest possible time.

“The good news is that the increased risk of breast cancer begins to fall once you stop using HRT. “If anyone is at all worried about either HRT or breast cancer, we’d highly encourage you to speak to your GP.”

The Lake Foundation believes that women considering using the combined HRT should have a discussion with their doctor about the pros and cons and make an informed decision about whether to proceed with treatment. If you can avoid combined HRT we would recommend that you do so.

You can download the full research paper below.