Breast and heart hormonal updates…
Dr Heather Currie past chair of the BMS delivered a talk at the recent BMS Conference in Stirling on breast and heart hormonal updates – she has to be one of the best speakers I have come across – you know you can have complete confidence in what she is saying given her vast experience and commitment to the subject of menopause. I would encourage any HCP if you hear she is speaking anywhere to go and listen – you will always learn something.
Some of the main points made…
It’s important to realise that the highest mortality rate for women is now from Alzheimer related illnesses rather than cardio vascular illnesses, which come a close second. There remains the misconception amongst a large proportion of women that it is breast cancer.
There is also the misconception that HRT causes breast cancer – the current research shows that HRT can act as a promotor rather than an initiator in relation to breast cancer, meaning that of the, roughly, 4 in 1000 women who take HRT that go on to develop breast those 4 women would more than likely have developed it anyway but maybe at a slower rate. HRT is often blamed for the development of breast cancer but put into perspective it can take up to 10 years for cancer cells to develop into a tumour, another important point which backs up the theory that HRT only acts to speed up the reproduction of cancer cells only if already present.
Oestrogen is known to have a protective effect on the heart and from a cardiovascular angle is at its safest to take in the 10 years after starting perimenopausal symptoms – commonly known as the ‘window of opportunity’. For a long time now many GPs have taken women off HRT as a safety precaution in relation to heart and breast health but research shows that women can now remain on HRT indefinitely, especially if on reduced levels and with obvious regular monitoring. It has also been shown that some women, who were denied the opportunity to be prescribed HRT, due the the misplaced media coverage in 2002, can now safely be prescribed low levels of HRT. These women would obviously have to have a comprehensive medical check first but for the first time in years some women are now experiencing sheer relief from persistent menopausal symptoms, particularly long term ones such as joint aches and genitourinary symptoms.
Breast pain (mastalagia) : Sometimes during the menopause with hormone fluctuations women can experience breast pain. Similarly some women experience mild breast pain if they start taking HRT, this can settle down and as with any hormone therapy should be given a certain length of time for your body to adjust. If symptoms persist then the dosage could be altered or the route of delivery changed – transdermal being the preferred route for many, also being the safest from a cardiovascular angle.
It remains important to raise the awareness of the long term effects of oestrogen deficiency on heart and bone health and to realise the ever increasing burden on the NHS with the populations lifestyle choices which have resulted in increasing obesity and excessive alcohol related illnesses.
Women are much more likely to develop breast cancer if they have excessive alcohol levels or if they are obese.
A brilliant chart on the BMS website which all women should see and if you are a HCP very useful to have a copy in your surgery to show patients :https://thebms.org.uk/_wprs/wp-content/uploads/2016/04/WHC-UnderstandingRisksofBreastCancer-MARCH2017.pdf
It is such an important message to get across – I bang on about lifestyle choices all the time but elementary things like having a really good look at what you are eating and how much you are exercising is incredibly important not just in relation to breast cancer but for many health issues … type 2 diabetes, cardio vascular problems, bone health… the list goes on.
So grab your space hopper, skipping rope or hoola hoop – whatever floats your boat and get active! Watch what you eat have a look at a previous post : http://letstalkmenopause.co.uk/nutrition-menopause-oh-yes-makes-difference/ You will honestly be amazed what a difference it makes to your mind and body and for those of you who have been put off HRT by misinformation and are still suffering even after addressing lifestyle choices I would encourage you to go and make an appt to see someone but make sure they know what they are talking about – your prescription is only as good as your prescriber!
Don’t forget to always examine your breasts : https://www.breastcancer.org/symptoms/testing/types/self_exam
Useful reading : http://letstalkmenopause.co.uk/female-hormones-many-ps/