HRT and Cancer Risks
Endometrial Hyperplasia and Cancer:
Estrogen-only HRT can increase the risk of excessive thickening of the womb lining (endometrial hyperplasia) and endometrial cancer. The progestogen in Utrogestan helps mitigate this risk by preventing abnormal growth of the womb lining.
Unexpected Bleeding:
While on Utrogestan, you will experience a monthly withdrawal bleed. If you encounter unexpected bleeding or spotting that:
- Continues beyond the first six months,
- Starts after six months of use,
- Persists after stopping Utrogestan,
consult your doctor promptly.
Breast Cancer:
Evidence suggests that combined estrogen-progestogen HRT, and possibly estrogen-only HRT, may slightly increase the risk of breast cancer. This additional risk becomes evident within a few years and generally returns to normal within five years after discontinuing treatment.
Risk Comparison:
For women aged 50 to 79 who do not use HRT, the average risk of breast cancer is 9 to 17 cases per 1,000 over five years. For those using combined estrogen-progestogen HRT, this risk rises to 13 to 23 cases per 1,000 users, an additional 4 to 6 cases.
Breast Self-Examination and Screening:
Regularly check your breasts and report any changes such as skin dimpling, changes in the nipple, or visible or palpable lumps. Participate in mammography screening programs when offered and inform the healthcare professional performing the mammogram that you are on HRT, as this may affect mammogram results due to increased breast density.
Ovarian Cancer:
Ovarian cancer is less common than breast cancer but can be associated with both estrogen-only and combined estrogen-progestogen HRT. The risk is slightly higher with HRT use. For example, in women aged 50 to 54 who do not use HRT, the risk is about 2 cases per 2,000 over five years. For those on HRT for five years, the risk is about 3 cases per 2,000 users, an additional 1 case.
Impact on Heart and Circulation:
Blood Clots (Thrombosis):
HRT increases the risk of blood clots in veins by approximately 1.3 to 3 times, particularly in the first year. Blood clots can be serious and may lead to conditions such as pulmonary embolism.
Risk Comparison:
For women in their 50s not using HRT, the risk of a blood clot is 4 to 7 per 1,000 over five years. For those using estrogen-progestogen HRT for more than five years, the risk increases to 9 to 12 per 1,000 users, an additional 5 cases.
Heart Disease:
There is no evidence that HRT prevents heart attacks. Women over 60 who use estrogen-progestogen HRT may have a slightly increased risk of heart disease.
Stroke:
The risk of stroke is about 1.5 times higher in HRT users compared to non-users, with the number of extra cases increasing with age.
Risk Comparison:
For women in their 50s not using HRT, the risk of stroke is 8 per 1,000 over five years. For those on HRT, the risk is 11 per 1,000 users, an additional 3 cases.
Other Considerations:
HRT does not prevent memory loss and may increase the risk of memory issues if started after age 65. Consult your doctor for advice on this matter.
Children:
Utrogestan is not intended for use in children.
Laboratory Tests:
If undergoing blood tests, inform the healthcare staff that you are on HRT, as it may affect certain test results.
Food and Drink:
Avoid taking Utrogestan with food. Refer to the section on dosage for proper administration timing.
Pregnancy and Breast-Feeding:
Do not use Utrogestan if you are pregnant or planning to become pregnant. It is for postmenopausal women only. If pregnancy occurs, discontinue Utrogestan and contact your doctor. Discuss use with your doctor if you are breastfeeding.
Driving and Operating Machinery:
Utrogestan may cause drowsiness or dizziness. Avoid driving or operating machinery if you experience these effects. Taking Utrogestan at bedtime can help minimize these effects.
Allergy Information:
Utrogestan contains soybean lecithin. Avoid using this product if you have an allergy to peanuts or soy.