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Is it necessary to fear the hormonal treatment of the menopause?

The hormonal treatment of menopause has long been controversial. Increased risk of breast cancer, fear of putting on weight…Yet, it is known to improve quality of life during this sometimes difficult period of life, and it is also known to bring obvious benefits in the fight against colon cancer and osteoporosis.

A much better quality of life
We know the hormonal treatment of menopause because it allows to fight against the many inconveniences related to this period of life, and in particular :

  • hot flashes and night sweats,
  • fatigue, sleep disturbances, irritability, emotionality, anger and sometimes even depressive tendencies,
  • Vaginal dryness and decreased sexual desire,
  • Aging with thinning and dryness of the skin, more prone to wrinkles,
    and sometimes increased hair growth or hair loss.

Hormonal treatment is usually based on estrogen and progesterone :

  • Estrogen is often administered through the skin, either continuously or with a break of a few days, either by applying a gel to the skin or by a patch to be stuck on containing the hormone and letting it filter through the skin.
  • Progesterone, in tablet form, is combined at least 12 days a month to protect the lining of the uterus and avoid any risk of cervical cancer.
    However, despite the real well-being it provides, it is often feared by women.

Why do women fear hormone treatment?

Two major reasons are given to explain a rejection of hormonal treatment:

  • Fear of gaining weight: however, contrary to popular belief, hormonal treatment does not cause weight gain if it is well dosed and balanced.
  • And above all the fear of breast cancer: the increase of this risk with hormonal treatment has long been controversial. There does indeed seem to be a very small increase in this risk when it combines synthetic estrogen and progesterone, but no risk with natural estrogen and progesterone.

Moreover, the conclusions of a series of 4 articles published in The Journal of Family Planning and Reproductive Health Care,  which had scrupulously scrutinized the methodology of numerous clinical trials involving hundreds of thousands of women, showed that the evidence was still insufficient: the researchers did not claim that hormonal treatment is harmless, but pointed out that there is no clear evidence that these treatments increase the risk of breast cancer.

However, as a precaution, doctors do not prescribe this hormone treatment in women with a personal history of breast cancer.

It is also important to remember that women who are on hormonal treatment always have regular gynecological follow-up (since the treatment is under medical prescription), thus allowing them to detect a cancerous lesion early, with a much better prognosis, whereas some women without treatment are never followed and are at risk of missing the onset of cancer.

In addition, apart from the fact that hormonal treatment improves the quality of life of women, it has other benefits that are often less known by the general population and yet not negligible for health.

Effective hormone treatment for colon cancer

Studies have shown that hormonal treatment of menopause, used continuously, reduces the risk of developing colon or rectal cancer.

The conclusions of a study of 57,000 postmenopausal women showed that estrogen-progestin hormone treatment followed for 5 years can reduce the risk of developing a colon tumor by 45%. The effect is less pronounced with estrogen-only treatment, which reduces the risk by only 17%.

A clear reduction in the risk of fracture

At menopause, the natural decrease of hormones causes brittle bones. Indeed, estrogens have a protective role for the bone by acting as a brake on bone destruction.

Hormonal treatment compensates for the lack of estrogen: it therefore helps to fight against osteoporosis, which considerably increases the risk of fractures. Numerous studies have shown that hormonal treatment reduces the incidence of vertebral or hip fractures by approximately 50%.

It should not be forgotten that osteoporosis is a pathology not to be taken lightly: in fact, it is often the cause of an altered quality of life (difficulty walking after a fracture, back pain, etc.), as well as an increase in mortality secondary to fractures.

With all these elements, it is up to you to make your own opinion, and if it seems difficult, do not hesitate to talk about it with your doctor.


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