HRT after breast cancer

Hi this is my first post, so I hope its in the right place!

I had a grade 2 stage 1 tumour removed very successfully in 2003, followed by 5 weeks of radiotherapy, then 5 years of Tamoxifen. Luckily no chemo was needed. I recovered well, but Id gone through the menopause naturally earlier in 2003 at the age of 48 (I sometimes wonder if thats what triggered the tumour?) so the Tamoxifen didn`t help with my fluctuating hormone levels.

Ive been seeing a gynae since I was 38 because of huge fibroids. For the last few years Ive been suffering badly from the effects of vaginal atrophy with soreness, itching, and cystitis almost every month. My gynae is advising the use of prescribed oral estrogen, even though my tumour was estrogen positive. He says its a question of quality of life - the vaginal atrophy will never go away, but the estrogen would relieve the symptoms, and if the cancer is going to come back, it will. I`ve been resisting the estrogen up to now.

My question is: has anybody else been in the same situation, and if they have, what advice would they give?

Many thanks in advance. OJ

Two comments: - did your gynae offer/discuss the use of topical oestrogen instead? (Just wondering if they thought topical wouldn’t help or would have the same risks anyway)

  • does your gynae work in the same hospital as your oncologist? Or can they discuss the issues together? (Much better for two experts to discuss the options and then talk to you about them, than for you to try and interpret pros and cons from two different perspectives, I think).

Good luck

I can only tell you my experience. I had menopause at 36 so was encouraged to take hrt for my general health. I came off it at 50 and three years later was diagnosed with E+ agressive breast cancer. So my answer would be, please don’t. I am paying for my so called quality of life in spades and I would not wish it on anyone else. I know this is contraversial, but I AM emotionally involved in this discussion and find it hard to remain unemotional. Please try alternative methods first. Then make your decision, but arm yourself with as much info as you can from all sources. Good Luck, and love

Having had ER+ breast cancer and oophorectomy I’ve been told by my oncologist, gynaecologist and GP that HRT is completely out of the question.

A female Consultant Gynaecologist I was referred to by my oncologist also told me it’s a question of each individual woman’s quality of life. She said they consider prescribing low dose HRT if the symptoms of the menopause are so extreme a woman finds them too difficult to cope with. I was referred for post menopause stuff, but had been told back in the late 80s I wouldn’t be a candidate for HRT as I had treatment for a precancerous change to my cervix in my 20s. What I’d say is there are all sorts of alternatives they can give you first.

I had topical oestrogen for vaginal atrophy/complete loss of libido. They told me it was one tenth of the normal dosage you would get from HRT in a week. Unfortunately I had to stop it as I had a couple of bleeds and you have to be referred for this. I’m 50 and now 5 years into post menopause,things are not great libido wise, but it does come and go. I also don’t miss my periods.

I too was diagnosed in 2003 WLE rads and Tamoxifen and then Arimidex until 7 years post diagnosis. When the lack of libido became a massive issue I approached my GP who wrote to an oncologist ( my original one having retired ) to see if I could have HRT - it was agreed that I could take a low dose formulation for a maximum of one year - working on the quality of life principle. I took it for one month felt no change whatsoever (!) and decided I didn’t like the ‘risk’ I felt I was taking.
Basically look into as much information as you can - get the opinion of as many ‘experts’ as you can - but remember that at they end of the day you have to do what you are comfortable with.

Good luck
Kathy x

Thank you all so much for your advice.

My menopausal symptoms stopped a long time ago and I didnt take HRT at the time. Ive tried topical estrogen cream (because its less invasive) but the very act of applying it triggered more cystitis.
My gynae and oncologist are at 2 separate hospitals, but I see my lovely sympathetic gynae on a regular basis and I haven`t seen an oncologist for 4 years.

Fortunately (!!!) I`m not in a relationship and having no libido is a relief after a life challenged by it. It seems a sad irony that I started my periods at 10, spent most of my life with quite bad mood swings and latterly dreadful periods, but although I feel 200% better generally since my periods stopped, I will spend the rest of my life with that part of my body giving me pain not pleasure. I wish I could just zip it up!

I am trying one teaspoon of virgin coconut oil a day as Ive read that its natural ingredient, lauric acid, is highly effective at combating all forms of infection in the body. I drink cranberry juice every day, and I also use lots of garlic when cooking.

Good luck to everyone. I am far more positive about the breast cancer than the cystitis, so if I can help anyone please contact me.
OJ x

If anyone else is having this problem, I found this webpage:

and will be asking my GP about Estring.

Best of luck everyone!

BTW, my Dad had two different cancers in his 50s - prostate and a bad melanoma on his lip. Both were cut out and he is still going strong at 87!

So glad I found this thread! I had been wondering about bone health protection and also it’s-just-your-age mental deterioration (“senior moments”, formerly known as being totally gormless).

All the older ladies in my family (and some of the younger ones too) have had bad osteoporosis and I would like (a) to live long enough to become an old lady and (b) to achieve this without being crippled in the process. Having had a strongly ER+ tumour with no known risk factors, I would also like (c) not to provoke a recurrence.

Now, the bone health thing is one that most people generally don’t worry about till it’s too late, so I had been planing on asking for a DEXA scan at 50, only BC got to me first; however the senior moments are getting beyond a joke. At only 51, I should be able to use E-bay and a DVD player, dammit.

Wondering how other ladies who have had premenopausal ER+ BC are dealing with this? If you google <bc hrt=“”> you either get to <br>
“HRT may cause BC” or “HRT after BC? Don’t!” without telling you the alternatives.</bc>

Bump! HRT after breast cancer, and I’m stunned by the silence. Does nobody else worry about their bones or expect to be able to think and function like a normal person? Hellooooo?

Hi Hymil,

I suppose what it bboils down to is that I worry more about recurrence of breast cancer than I do about thinning bones and mental functionality - it’s all a balancing act. Luckily no family history of osteoporosis or dementia in my case. Not planning to go down the HRT route but maybe I’ll think differently when I’m in hospital with a broken hip because I forgot there was a step outside my back door!

Anyway, all the best with however you decide to proceed.

Thank you! Oops, I totally forgot I had put about the family link with dementia too. LOL.

I guess I may be sticking my head in the sand about BC but can’t avoid the senior moments/days/weeks… You see, I quite like the exercise alternative to strengthen my bones, but only in good weather. Now when I were a lass, way back in the last century, droughts were proper droughts with no rain, simples. They knew how to behave, and they didn’t share a date with hailstones and flood warnings. But now it seems anything goes; Hey, maybe it’s no wonder I’m confused.

Hi I know everyone is individual and what effects one on a drug does not effect another but I have three younger sisters and I have advised all three of them not to take H R T. I went on it after I was diagonised as full menopausal at first it was wonderful all the hot flushes stopped and I felt great then a few years later I found a lump in my breast. My mind told me it could not be cancer no one in my family had breast cancer and prior to going on H R T I checked all the risk factors and I had none of them. Today I thank God I checked myself it was a grade 3 tumour further investigation revealed another was starting up in the same breast I was lucky I lost my breast but seven years on I am here to tell the tale. Today my consultant cannot tell me my own BC was not aided by the taking of H R T. I too am convinced it was. It may stop menopausal symptoms but as soon as I had to stop the H R T due to my cancer all my menopausal symptoms came back with a vengence. Then I started 5 years on tomoxifen followed by four year on Femara in hope my breast cancer would not return. I have now been on the Femara 19 months and today I am still having menopausal symptoms not from H R T but now Femara which also puts you at a higher risk of incurring osterporisis. I have had a dexa scan and I am pleased to say my bones are fine but to help keep them that way I consume plenty of low fat diary products and take calcichew-D3 tablets issued by my dr. You can buys these in a chemist. To take H R T or not has to be ones own choice but I am glad my sisters did not. I would say to all of you please think twice I have met so many ladies attending my own breast unit that were on H R T when their Breast Cancer was found - Coincidence ?

To me this has to be a big NO!

I am really shocked that your gynae has suggested this. I am a Royal Marsden patient and I have been told that after having a very very hormone receptive cancer that HRT will never ever be an option. My sister in law whoose mum died of BC who is 50 now was again advised by her GP that having HRT is too risky.

I had huge fibroids. I ended up having a hysterectomy Nov 2010 three months before I was diagnosed with cancer.

The way I see it is why have years of hormones supressed to help stop the cancer coming back, to then do the total opposite.

Even though you haven’t seen the Onc for 4 years doesn’t mean you can’t get advice. Why not ring his/her secretary and ask to speak to them or write a letter.

Re the cystitis, I think I’d be wanting to find out why applying the cream caused a problem. I don’t know how the cream is applied so excuse my ignorance but is it possible that some is getting pushed into the urethra and this is leading to infection? Is there something in the cream that might be an irritant - is there a different one you could try?

Elinda x