Doctor says increase in breast cancer risk, most serious side effect, is very low


Every woman experiences menopause.

Menopause is defined as when menstruation has ceased for more than a year.

Menstruation ceases for Korean women at an average age of 49.7 years old. Early menopause occurs between 45 and 49 and premature menopause before 45.

Menopause brings a variety of symptoms, including hot flushes, insomnia, night sweats, muscle pain, weight gain, skin troubles and an increased prevalence of osteoporosis and cardiovascular diseases. Symptoms ranging from mild to severe haunt women for a considerable period of time. Depression is also more common than usual.

Professor Park Hyoung-moo of Chung-Ang University Hospital, who heads the Korean Society of Menopause, recommends hormonal treatments for women who have experienced menopause because they could improve their lifestyle and reduce health risks.

“The importance of estrogen for women is quite huge,” Park said. “The skin dries out as it loses collagen and bones start to lose strength, becoming subject to easy fracture. Through HRM, one will be able to reduce the risk of osteoporosis, cardiovascular diseases, hypertension, abdominal obesity and even dementia. Instead they will boost their sexuality and health-related quality of life.” 

“Hormone replacement therapy could be the most effective way to counter various symptoms seen in those who have experienced early or premature menopause,” he said, adding that it was better to start the treatment within five years of the menopause.

Those who keep their uterus until then are prescribed with the mixture of estrogen and progesterone, while those who have had hysterectomies are given estrogen only.

Still, many women are reluctant to take the treatment out of fear of breast cancer. Many international reports claim that it is the most significant side effect of HRM.

However, Park says the chance of breast cancer breakout as side effect is eight per 10,000 patients and is even lower among Asian women.

“Study results suggest that the breast cancer risk is recognizable only after 15 years into therapy. That means if the treatment is held for less than 15 years, the chance of getting breast cancer is not significant,” he said.

Park noted that HRM is effective on those younger than 60 years old and that women should start the treatment in earlier stage of menopause.

“We have gathered evidence that after 60 years old, artificial injection of hormones could cause adverse effects such as prevalence of breast cancer and cardiovascular diseases,” he said.

He stressed that the patients must consult with doctors regularly while receiving the hormonal treatment.

“Individuals have different characteristics and you cannot make a uniform prescription. Tailored therapy is needed. With sufficient care and alertness, we won’t have to worry too much about side effects,” he said.

Those who are pregnant or have experienced abnormal uterine bleeding are also not allowed to be treated with hormones. During or after the therapy, one should stay away from alcohol and tobacco. Efforts to lose weight are also needed since menopause is known to cause weight gain of around 3-5 kilograms in the abdominal areas but this could lead to cardiovascular and other diseases.

Park advised women to modify their lifestyles.

“Calcium is important. About 1,200 milligrams of calcium and 800 international units (about 20 mg) of vitamin D a day are essential. If you cannot get much of this through food, take supplements. An average Korean woman takes in only 500 to 600 milligrams of calcium a day.

“Exercise regularly: More than 30 minutes per session three times a week is necessary, too,” he said.

The academy is currently giving lectures nationwide on how to overcome post-menopausal syndrome. More information about the schedule is on http://www.koreanmenopause.or.kr.

By Bae Ji-sook (baejisook@heraldcorp.com)