Menopause & Cancer
With the improvements in cancer therapy, there are more children, adolescent and young women cancer survivors. A significant proportion of women will have been exposed to chemotherapy and/or radiotherapy which might induce premature ovarian insufficiency (POI). It’s important that women with POI are offered HRT up until the age of 51 to prevent the complications of prolonged oestrogen deficiency such as menopausal symptoms, reduced bone mineral density and increased risk of cardiovascular disease.
Most cancers are not oestrogen-related cancers and HRT can be safely prescribed once treatment is completed. This includes (and is not confined to)vulval,vaginal, cervical, colorectal and lung cancer. There are also several non-hormonal treatment options available to cancer survivors who do not wish to avail of HRT.
Oestrogen-receptor positive breast cancer, however, is a contraindication to HRT. The NICE guidelines acknowledge that some women with a previous history of breast cancer have severe debilitating menopausal symptoms refractory to non-hormonal interventions, and in some rare scenarios HRT may be prescribed as long as informed consent is obtained regarding the potential for increased risk of recurrence and the oncology team has been consulted.