Medical Questions » Menopause Questions » Question No. 668
| Question: | I am 58 years old and recently started on hormone replacement therapy with Premarin tablets prescribed by my GP. Another GP I consulted for a second opinion is most alarmed that taking this drug alone will increase my risk of cancer. I am confused! Which GP is right? |
| Answer: | Hormone replacement therapy is of great benefit to the majority of women who are menopausal, and there is sometimes a period of trial and error in getting the doses and balances of hormones just right.
In the majority of women, both an oestrogen (such as Premarin) and a progestogen (eg. Provera, Primolut) should be taken, as these are the two hormones that are normally present during your reproductive life.
If oestrogen is taken without progestogen, there is over stimulation of the tissue in the uterus (womb) which can increase the risk of cancer of the uterus. When the two are taken together, either cyclically (progestogen for only part of the month) or constantly (both hormones all the time) there is no increased risk of uterine cancer.
In a hysterectomy your uterus is removed, and so women who have had a hysterectomy cannot have an increased risk of cancer of the uterus, and these women only need to take the oestrogen. Progestogens are usually unnecessary.
If you have had a hysterectomy, the first GP was right (oestrogen only is necessary). If you have not had a hysterectomy, you should follow the advice of the second GP (take both oestrogen—Premarin, and progestogen).
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