What are the risks in taking HRT (cont'd)

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Coronary heart disease

Coronary heart
disease refers to disease of the coronary (heart) arteries. It is the
usual cause of angina and heart attacks. So far, studies have shown
that oestrogen-only HRT does not seem to increase your risk of
coronary heart disease. However, trials have shown that in women who
start combined HRT more than 10 years after their menopause, there is a
small increased risk of coronary heart disease. There are only a few
trials that have looked at younger women who have started HRT at an
earlier stage. However, some of these trials have suggested that these
women have a lower risk of heart disease with HRT compared to older
women and that HRT may even be protective.

Cancer of the uterus (womb)

There is an
increased risk of cancer of the uterus due to the oestrogen part of
HRT. By taking combined HRT containing oestrogen and progesterone, this
risk reduces significantly (see above). This is the reason why
progestogen is included in HRT. However, you should always see your
doctor if you have any abnormal vaginal bleeding which develops after
starting HRT. For example, heavy bleeding, irregular bleeding or
bleeding after having sex.

If you have had a total hysterectomy for whatever reason, you should only need to take oestrogen-only HRT.

Cancer of the ovary

There is a slightly
increased risk of developing this cancer if you use oestrogen-only HRT
or combined HRT. This risk decreases after you stop HRT.

If
either combined or oestrogen-only HRT is taken for five years or less,
this increased risk is thought to be very small (there will be less
than one extra woman who develops ovarian cancer per 1,000 women taking
HRT). If HRT is taken for 10 years, there will be between 1-2 extra
women who develop ovarian cancer per 1,000 women taking HRT.

Dementia

If you start HRT after the age of
65, it is not thought to protect against dementia. Also, combined HRT
may increase the risk of dementia in women over the age of 75 years.
HRT is not advised to help prevent dementia.

Other points about risks

So, there is a
small but definite increased risk of serious illness when using HRT.
But note: your risk of developing the diseases mentioned above depend
on a combination of many factors. For example, your family history, and
lifestyle factors such as smoking, obesity, diet, etc, which can also
affect your risk. You can greatly reduce your risk of developing heart
disease and stroke by not smoking, taking regular exercise and eating a
healthy diet. These conditions become more common anyway with advancing
age. But, if you take HRT, this is now another factor to consider.