Climacteric Complaints after Breast Cancer – Is HRT an Option?

Abstract

Systemic estrogen depletion is the mechanism of action of most endocrine treatment strategies, and a common side effect of most chemotherapy regimens that are currently used to treat invasive breast cancer. The ensuing immediate and profound decline in estrogen levels is, however, often associated with considerable climacteric complaints. While oral estrogen add-back therapy is effective in alleviating menopausal symptoms, it is feared that it might also promote tumor cell growth. This concern is largely based on circumstantial evidence from large trials in healthy women, in which hormone replacement therapy (HRT) resulted in a slight, albeit significant, increase in incident breast cancer. In breast cancer survivors, however, evidence from studies remains controversial. Despite these caveats, the severity of symptoms and the lack of effective alternatives still cause many women to opt for HRT. Nevertheless, HRT cannot generally be recommended as first-line therapy for climacteric complaints in women with a history of breast cancer. It may, however, be a valid option for selected women with climacteric symptoms refractory to previous non-hormonal treatments. In these cases, an individualized riskbenefit analysis is imperative before treatment initiation, and a treatment duration of less than 5 years with intermittent withdrawal attempts should be aimed for.

Polygonatum stenophyllum improves menopausal obesity via regulation of lipolysis-related enzymes

“…In particular, the prevalence of obesity after 40 years of age significantly increases up to 65 % between 40 and 59 years and 73.8 % over 60 years [10]. Accordingly, hormone replacement therapy (HRT) has been used to alleviate menopausal symptoms [11]. However, development of alternative treatments is required because of side effects such as breast cancer and endometrial hyperplasia, though use of HRT is of benefit for estrogen recovery [12][13][14].…”