According to a recent article published in the

Journal of the American Medical Association, women treated with some forms of hormone replacement therapy may be at a higher risk for developing ovarian cancer, particularly long-term use of estrogen only.

Hormone replacement therapy (HRT) is typically prescribed for women during menopause. Menopause is a natural phase of maturing womanhood, during which ovaries produce significantly less estrogen, ovulation ceases and menstruation ends. For many women, menopause has uncomfortable side effects. Hot flashes, sleep disturbances, depression, mood swings and anxiety may affect the menopausal woman. Additionally, menopause may also be accompanied by increased urinary tract infections, incontinence, vaginal discomfort due to a lack of estrogen-based lubrication and decreased bone density. HRT has been effectively used to mitigate these side effects and is widely prescribed for women experiencing these unpleasant symptoms of menopause. Despite these benefits, however, some clinical studies suggest that HRT use, particularly for extended periods of time, may increase the risk of developing breast cancer and uterine cancer.

HRT may include either estrogen alone, or estrogen combined with progestins, a female hormone that, among other roles, induces shedding of the uterine lining during menstruation. Progestins are added to HRT to reduce the risk of the development of uterine cancer that occurs with the use of estrogen alone.

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Twenty-nine medical centers in the United States participated in the Breast Cancer Detection Demonstration Project and evaluated 329 women who developed ovarian cancer during follow-up of the project. Rates of ovarian cancer increased every year in women who were taking estrogen-only HRT. Rates of ovarian cancer in women taking short-term and long-term HRT consisting of estrogen and progestins were not increased. However, these researchers state estrogen-progestin HRT use and subsequent risks of ovarian cancer warrants further investigation.

These researchers concluded that estrogen-only HRT, particularly long-term use, significantly increases the risk of the development of ovarian cancer. Results from several clinical trials regarding HRT use and side effects have recently been published, and postmenopausal women either taking HRT or experiencing post-menopausal symptoms should speak with their physician about the specifics of these results and the risks and benefits of HRT posed to them.

Reference: Lacey J, Mink P, Lubin J, et al. Menopausal hormone replacement therapy and risk of ovarian cancer.

Journal of the American Medical Association. 2002;288:334-341.

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