Fed: Women warned off homemade HRT after cancer link

AAP General News (Australia)
08-19-2007
Fed: Women warned off homemade HRT after cancer link

By Tamara McLean, Medical Writer

SYDNEY, Aug 19 AAP - Women taking a homemade form of hormone replacement could be putting
themselves at risk of cancer of the uterus, reproductive experts have warned.

In a world first, Australian specialists have identified three cases of women who developed
endometrial cancer after taking so-called "bioidentical" hormone replacement therapy (HRT).

It is believed that thousands of Australian women are on the therapy, which is an unbranded,
unregulated form of standard HRT supplied by some pharmacists and online.

It is promoted as a more "natural" form of HRT, used widely to treat the symptoms of
menopause like hot flashes and night sweats.

Biomedical HRT has been suspected of being linked to cancer but this study, published
in the latest Medical Journal of Australia, is the first proof of a clinical pattern.

Dr John Eden, associate professor of reproductive endocrinology at the University of
NSW, and his co-authors, said that taking oestrogen was known to increase risk of endometrial
carcinoma.

For this reason, standard HRT approved by the Therapeutic Goods Administration contains
a careful counterbalance of progestin, a synthetic form of progesterone, known to lower
the risk.

But in bioidentical HRT, which is untested, the dose balance of hormones can differ,
raising risk of disease, Dr Eden said.

He suggests the cases of the three NSW women - two who were menopausal and one who
was still getting periods - raise the possibility that bioidentical HRT increases the
risk of developing cancer as a result of high levels of oestrogen.

"It should be noted that the Australasian Menopause Society does not recommend the
use of bioidentical HRT," Dr Eden said.

"Until this therapy has been properly tested, it may be prudent not to advocate bioidentical
HRT, and to perform annual ultrasounds and biopsies on women who continue to use this
therapy."

Sydney reproductive health specialist Professor Michael Chapman said bioidentical HRT
was promoted by many pharmacists and specialists who believed the doses, taken either
as a lozenge or as a cream that is rubbed in, were more appropriate than standard HRT.

"These women take what they believe are the right hormones at right doses but that's
not necessarily the case," Prof Chapman said.

"The hormones are bought from the same sources as drug companies but the difference
is the stringency for testing is huge."

He warned women off the treatment, saying it was "crazy for people to endanger themselves
like this when there is a range of much safer and tested products on the market".

AAP tam/goc/de

KEYWORD: HORMONE

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