Hormone Therapy and Ovarian Cancer

“Ovarian cancer is a rare condition but all the risks and benefits of hormone therapy need to be carefully considered when treating women at menopause”.1

<h2Umbrella

What may the Hormone Therapy and Ovarian Cancer Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Cancer of the Ovary
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Menopausal Hormone Replacement Therapy (MHT)
  • Ovarian Cancer

Ovarian Cancer Risk

Does the use of hormone therapy (HT) increase the risk of ovarian cancer?

On page 783 in The 2022 Hormone Therapy Position Statement of The North American Menopause Society: Ovarian Cancer – Key Points published July 2022 and “endorsed by more than 20 well-respected international organizations”, two of the key points are:

  • “Current and recent use of hormone therapy is associated with a small but statistically significant risk of ovarian cancer in observational studies, principally for serous type, although there was no increase in ovarian cancer risk in women randomized to EPT in the WHI. (Level II)
  • In women with a history of ovarian cancer, benefits of hormone therapy use generally outweighs risks, especially with bothersome VMS or early menopause; use of hormone therapy is not advised in women with hormone-dependent ovarian cancers, including granulosa-cell tumors and low-grade serous carcinoma. (Level II)”.2

What is EPT?

EPT can be an abbreviation for Estrogen Plus Progestogen Therapy.

What is WHI?

WHI can be an abbreviation for the Women’s Health Initiative.

What is VMS?

VMS can be an abbreviation for Vasomotor Symptoms such as hot flushes and night sweats.

What is Level II?

Level II is “Based on limited or inconsistent scientific evidence”.

Combined HRT

Does combined hormone replacement therapy (HRT) increase the risk of ovarian cancer?

In Does Hormone Replacement Therapy (HRT) Increase the Risk of Cancer? Does Combined HRT Increase the Risk of Cancer?, last reviewed 22 March 2023, the (United Kingdom) Cancer Research UK note:

  • “Ovarian cancer: combined HRT slightly increases the risk of ovarian cancer. When HRT is stopped, the increased risk starts to go back down”.3

Oestrogen-Only HRT

Does oestrogen-only HRT increase the risk of ovarian cancer?

In Does Hormone Replacement Therapy (HRT) Increase the Risk of Cancer? Does Oestrogen-Only HRT Increase the Risk of Cancer?, last reviewed 22 March 2023, the (United Kingdom) Cancer Research UK note:

  • “Ovarian cancer: Oestrogen-only HRT slightly increases the risk of ovarian cancer. When HRT is stopped, the increased risk starts to go back down”.4

2015 Meta-Analysis

What was the Collaborative Group on Epidemiological Studies of Ovarian Cancer’s Interpretation in their Meta-Analysis?

In Menopausal Hormone Use and Ovarian Cancer Risk: Individual Participant Meta-Analysis of 52 Epidemiological Studies – Summary (Meta-Analysis) published 12 February 2015, the Collaborative Group on Epidemiological Studies of Ovarian Cancer’s Interpretation was:


Hormone Therapy and Ovarian Cancer“The increased risk may well be largely or wholly causal; if it is, women who use hormone therapy for 5 years from around age 50 years have about one extra ovarian cancer per 1000 users and, if its prognosis is typical, about one extra ovarian cancer death per 1700 users”.5

What did the Australasian Menopause Society (AMS) note about the Meta-Analysis?

In Short-Term Use of Hormone Replacement Therapy (HRT) and Ovarian Cancer Risk: Comment From AMS the AMS President’s comments note:

“Ovarian cancer is a rare condition but all the risks and benefits of hormone therapy need to be carefully considered when treating women at menopause.

Women should not stop hormone therapy based on this study but if they are concerned they should discuss the findings with their doctor”.6

Health Care Provider

If I choose to use hormone therapy (HT) what is my risk of ovarian cancer?

Different women who choose to use HT can have different risks of ovarian cancer. It may therefore be in your best interest to also choose to ask your health care provider about this.

On page one in Deciding About Hormone Therapy Use, published 2022, the North American Menopause Society explain:

“Every woman is different, and you will decide about whether to use HT based on the severity of your symptoms, your personal and family health history, and your own beliefs about menopause treatments. Your healthcare professional will be able to help you with your decision”.7

Health Topics A-Z

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In Health Topics A-Z you may find:

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  36. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Hormone Replacement Therapy (HRT) [+ Video: Is HRT Bad for You?] [Other Languages and Formats]
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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Short-Term Use of Hormone Replacement Therapy (HRT) and Ovarian Cancer Risk: Comment From AMS. Content Updated: 17 February 2015. Australasian Menopause Society https://www.menopause.org.au/hp/news/729-short-term-use-of-hrt-and-ovarian-cancer-risk Accessed: 05 May 2024
  2. The 2022 Hormone Therapy Position Statement of The North American Menopause Society: Ovarian Cancer – Key Points. July 2022:783. North American Menopause Society  https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf Accessed: 05 May 2024
  3. Collaborative Group on Epidemiological Studies of Ovarian Cancer. Menopausal Hormone Use and Ovarian Cancer Risk: Individual Participant Meta-Analysis of 52 Epidemiological Studies – Summary: Interpretation. 12 February 2015 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61687-1/fulltext Accessed: 05 May 2024
  4. Does Hormone Replacement Therapy (HRT) Increase the Risk of Cancer? Does Combined HRT Increase the Risk of Cancer? Last Reviewed: 22 March 2023. Cancer Research UK https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/hormones-and-cancer/does-hormone-replacement-therapy-increase-cancer-risk Accessed: 05 May 2024
  5. Joint RCOG/BMS Statement: Lancet Study Examines Use of HRT and Ovarian Cancer Risk. Royal College of Obstetricians and Gynaecologists. 13 February 2015 https://thebms.org.uk/2015/02/joint-rcogbms-statement-lancet-study-examines-use-of-hrt-and-ovarian-cancer-risk/ Accessed: 05 May 2024
  6. Short-Term Use of Hormone Replacement Therapy (HRT) and Ovarian Cancer Risk: Comment From AMS. Content Updated: 17 February 2015. Australasian Menopause Society https://www.menopause.org.au/hp/news/729-short-term-use-of-hrt-and-ovarian-cancer-risk Accessed: 05 May 2024
  7. Deciding About Hormone Therapy Use. 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 05 May 2024
Topic Last Updated: 30 May 2024  – Topic Last Reviewed: 05 May 2024

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