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What is Menopausal Hormone Therapy?

Menopausal Hormone Therapy (MHT) is widely prescribed for postmenopausal women to ease symptoms of menopause such as hot flashes, vaginal dryness, and sleep disturbances. 

There are two types of Hormone Replacement Therapy (HRT):

According to recent research, it has been found that Combination Menopausal Hormone Replacement Therapy increases the risk of breast cancer by 75%, even when administered for a very short time. In contrast, estrogen-only hormone therapy increases the risk of breast cancer only when used for longer than 10 years.

What Are The Health Effects Of Menopausal Hormone Therapy?

How Does Genetics Influence Breast Cancer Risk with Menopausal Hormone Therapy?

Some genes promote higher growth of estrogen receptors during menopausal hormone therapy. This increases the risk of ER-positive breast cancer. 

The CYP19A1 Gene

The CYP19A1 gene contains instructions for the production of a protein involved in estrogen biosynthesis. 

Certain changes in this gene are associated with poor treatment outcomes of hormone therapy in women in the early stages of ER-positive breast cancer. 

The POMP Gene

The POMP gene contains instructions for the production of proteasome maturation protein. A study revealed two regions in the POMP gene showing interaction with hormone therapy that increased the risk of breast cancer.

Non-genetics Factors that Influence Breast Cancer Risk with Menopausal Hormone Therapy

Obesity: According to a study published in Cancer Epidemiology Biomarkers in 2008, both types of hormone therapy are associated with breast cancer risk. The risk is further influenced by the body mass of the individual and the clinical characteristics of the tumors

In women with BMI <25 kg/m2, estrogen therapy was associated with a 60% increase in breast cancer risk after 10 years of the therapy. The risk increased with combined therapy. Combined therapy with estrogen and progesterone was also strongly associated with ER-positive tumors.

Alcohol consumption: Drinking alcohol while taking postmenopausal hormone replacement therapy can increase the risk of developing breast cancer. This is because drinking alcohol increases estrogen levels, and when combined with the estrogen in hormone therapy, it significantly increases estrogen in a woman’s body.

A study was conducted to analyze drinking habits and hormone therapy use in over 5,000 Danish women for over 20 years. The researchers found that postmenopausal women who took Hormone Replacement Therapy (HRT) and drank 1 or 2 alcoholic drinks per day had three times higher risk of breast cancer than women who did not drink and were not taking HRT. Also, postmenopausal women taking HRT who drank more than 2 alcoholic drinks per day had a five times higher risk of breast cancer than women who did not drink and were not taking HRT.

Smoking: Smoking has been associated with an increased risk of breast cancer in women. This risk is much higher for women who smoke while taking postmenopausal hormone therapy.

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