Absent and Infrequent Periods: HRT

The majority of women with a premature menopause will have typical menopause symptoms (Chapter 26) which can be controlled by hormone replacement.

Most of the information available on hormone replacement relates to the vast number of women who have a normal menopause (in their early fifties). There is very little data for women taking hormone replacement earlier in their lives. It would seem that for each year that the body has natural oestrogen either as a result of a late natural menopause or as result of hormone replacement, there is a slightly increased risk of breast cancer. This increased risk is small and the majority of women who develop breast cancer whilst taking hormone replacement would have developed the cancer even if they had never taken hormone replacement (Q 27.15). For those who have a premature menopause, and who do not take hormonal treatment, the risk of breast cancer is reduced. It is difficult to extrapolate evidence from one group and apply it to another. Nevertheless, the current opinion seems to be that if a woman with a premature menopause takes hormone replacement until the age of fifty, the risks of breast cancer increase to those of a woman who has a natural menopause at the age of fifty.

The risks of a woman with a premature menopause having sustained oestrogen deficiency are reduced bone density and cardiovascular disease (Chapter 26). From the information currently available, the benefits of hormone replacement are thought to be greater than the risks.

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