If breast cancer runs in your family, deciding whether to take menopause hormone therapy (MHT) during perimenopause or menopause can feel overwhelming. At MyMenopauseRx, we believe in providing women with clear, evidence-based guidance, especially when fear and misinformation online, from family, friends, or your own OB/GYN or PCP, cloud the conversation.  Let’s demystify the facts so you can feel confident in your decision.

First, what is MHT?

Menopause Hormone Therapy (MHT) is an FDA-approved prescription medication used to relieve symptoms that may occur as your body naturally loses estrogen, progesterone, and testosterone during perimenopause and menopause.

Some common symptoms include:

• Hot flashes and night sweats
• Mood swings and anxiety
• Brain fog and memory issues
• Vaginal dryness and discomfort
• Sleep disturbances and fatigue
• Decreased libido
  

MHT does more than just ease symptoms. It can also help prevent:

• Osteoporosis and fractures
• Heart disease
• Type 2 diabetes
• Depression
• Some cancers, like bowel cancer

What if breast cancer runs in my family?

You're not alone. Many women have a family history of breast cancer. In fact, 1 in 8 women will be diagnosed with breast cancer in their lifetime. But here's what’s important to know: only about 10% of breast cancers are linked to inherited genes.

For most women, having a family history of breast cancer does not mean you can’t take MHT. The overall risk of developing breast cancer from MHT is small, and even lower when using body-identical hormones, like micronized progesterone and estradiol.

The type of MHT influences your risk of developing breast cancer.

Micronized (body-identical) progesterone has not been shown to increase breast cancer risk. Synthetic therapeutics like medroxyprogesterone acetate (Provera) was found to slightly increase your risk compared to those who use no synthetic MHT. But even for those taking the synthetic progestogen, the added risk of breast cancer is very low and is less than drinking a couple of glasses of wine each night or being overweight.

And this fact, found from the Women’s Health Initiative Study that created all the fear over 20 years ago, is powerful proof that estrogen is not the evil hormone it’s been blamed to be all these years: According to the study, for those taking estrogen alone, after a hysterectomy, you lower your risk of breast cancer compared to never taking MHT by about 23%.

But what if I carry the BRCA gene or have a really strong family history?

There is no strong evidence that having a family history of breast cancer puts you at any higher risk of getting breast cancer, despite the fears instilled in you by others.   Only about 10% of women with a family history of breast cancer actually have a genetic or familial cause. The current literature even supports that if you’ve been diagnosed with a BRCA gene mutation, you may still be able to use MHT,  especially if you had your ovaries removed as part of a risk reduction plan.

As always, the decision to use MHT is not one-size-fits-all.  At MyMenopauseRx, our certified menopause practitioners personalize your care plan based on your full medical history, lifestyle, and personal goals.

So, should I take MHT?

The answer depends on you. But here's what we know: for most women, even those with a family history of breast cancer, the benefits of MHT outweigh the risks when begun before age 60 and within 10 years of your menopause.

If you’re suffering from menopause symptoms, you don’t have to make the decision to begin MHT alone. Book a visit with one of our menopause-certified clinicians. We’ll help you navigate your options with science, not fear.

Your Health, Your Choice. Powered by MyMenopauseRx.

1. American Cancer Society. Breast Cancer Risk Factors. https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-

2. Fournier A, Berrino F, Clavel-Chapelon F. Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. Int J Cancer

3. The North American Menopause Society. 2022 Hormone Therapy Position Statement. https://www.menopause.org/docs/default-source/professional/nams-20224.

4. Anderson GL, et al. Conjugated equine estrogen and breast cancer incidence and mortality in postmenopausal women with hysterectomy: WHI trial. Lancet Onc

5. Rebbeck TR et al. Hormone replacement therapy after oophorectomy and breast cancer risk in BRCA1 and BRCA2 mutation carriers. J Clin Oncol. 2005.

6. Michelsen TM et al. Hormone therapy after risk-reducing salpingo-oophorectomy in BRCA mutation carriers: A systematic review. Climacteric. 2022.

7. Manson JE et al. Menopausal hormone therapy: new findings and clinical implications. JAMA. 2017.

8. The Lancet Oncology. Type and timing of menopausal hormone therapy and breast cancer risk. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2049.

9. Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta