His and Her Health

This story is alarming:

http://www.cnn.com/2006/HEALTH/conditions/12/14/breast.cancer.decline.ap/index.html

It seems to imply that since women stopped taking HRT breast cancer rates have dropped %7.2. That's a big drop.

On the plus side, I'm certainly happy that breast cancer rates are dropping! But where does that leave women going through menopause? My sister had a hysterectomy at a young age and is so depressed about this news. HRT has made her life bearable and now she feels she's going to have to give up her sex life - not to mention her bone density (she's already got osteo-something - the precurser of osteoporosis) and other severe symptoms. When she asks doctors about the loss of libido/orgasm, all they say is, "Yeah, we hear that a lot. There's no treatment."

From what I've read in the past it's mostly related to people taking estrogen and progestin together, right? I'm assuming that topical estrogen or topical testosterone is not at issue. I've been told the doses are small and non-systemic.

I know Shirlr will drag me over the coals about this, but I'd have to think really hard about not using HRT if that were the only way to keep my quality of life. I'm not using it now, but I'm so afraid I'm going to need it and it won't be available. This is so frustrating.

Welcome to my world. Sex hasn't been the same for me since I began breast cancer treatment in March of 2003. It's gotten better - it's actually not too bad - but it just isn't the same. If there was a safe HRT I would be on it in a hearbeat. I am beyond frustrated.

However, having breast cancer is a hell of a lot worse than a diminished sex life. Quality of life takes on a whole new meaning when you have cancer. Disfiguring surgery, radiation, and chemotherapy aren't a walk in the park. Not to mention being constantly scared that every ache and pain may be the cancer coming back somewhere else.

By the way, I never took HRT. I was not menopausal when I was diagnosed.

What troubles me is that medical science hasn't come up with a safe and effective way to combat this problem. Millions of women suffer from sexual problems related to menopause and there hasn't been anything meaningful to offer them other than HRT, which we now know is dangerous. I've been given the "yeah, we hear that a lot" line so many times I could puke. It makes me really angry. And don't even get me started on "Menopause - The Musical." Think hot flashes are funny? Go stick your head in an oven.

Having said that,eva, I think every woman should make the medical decision that's right for her. I have girlfriends on HRT and I support their choice, even though I worry about them. I chose to discontinue taking Tamoxifen because the side effects were negatively impacting my quality of life. In making that decision I am taking a small risk of a recurrence, but that's my choice. You have to evaluate all the risks and make an informed decision.

I'd give anything to get back the level of arousal and the ability to have dependable orgasms I lost. But taking a gamble on getting cancer by taking HRT just isn't worth it for me.

I think this news is just reaffirming the fact that there is no "one size fits all" solution (as they say). Shirlr, for you and your history of breast cancer, HT is obviously not the right choice for you.

But, for some women who do not have a family history of breast cancer and who have weighed all their risks associated with HT, and whose hot flashes are uncontrollable (taking over their lives), HT might be the right choice for them.
Also, more women need to know their alternatives. Some women may not even know that exercising more or taking botanicals may help their hot flashes. Wouldn't that be a shame if they didn't try those things before going on HT?

I think the breast cancer drop is good news. And, as more results are released, there may be an even stronger correlation to it and HT. In my opinion, right now, we only know half of the picture. What happened after 2003? Did rates continue to drop? Did women continue to stop using HT? There seems to be a lot missing from the picture, no?

+++Moderator's Note
RJG is an Editor at REDHOTMAMAS.org

<small>[ 12-18-2006, 10:31 AM: Message edited by: Moderator ]</small>

Sorry if I seem on edge today. No one in Seattle got very much sleep last night.

One noteworthy thing in the article I read about this study is that since breast cancer takes many years to grow to a size that can be detected, a theory is that, for the women in this study, stopping HRT may have caused their undetected tumors to stop growing to a size where they could be found in a mammogram. It doesn't necessary mean they had less cancer. Some of these women may still be diagosed in the future.

However, this does reinforce what my oncologist told me, that estrogen acts as fuel for estrogen receptor positive tumors (which applies to about 70% of all breast cancers) and starving the tumor of estrogen will keep it from growing.

I take suppliments and exercise and still have troublesome menopause symptoms. But the issues that bother many of us the most are the sexual ones. That's why most women want HRT for long term use, in my experience. And it just isn't safe for that use, based on everything I've read.

By the way, not having a family history of breast cancer is not a green light for taking HRT. I had no family history or other known risk factors. Most breast cancer patients don't.

I've been offline for a few days. I'm in the Seattle area, like Shirlr and it's been hell on wheels around here the last few days. We have had no power since last Thursday and no idea when it will return. It's currently 41 F INSIDE the house and we've moved our family in with a relative for the time being.

But while I was offline I thought a lot about what I had written at the start of this thread and have been trying to figure out why orgasms are so important to me. It's more than just that they feel good. I know it's not the same for everyone but it's always been something central for me. I rarely go more than 24 hours without one and feel like a part of my identity would be gone without them. Comments from other women about orgasms not being the main reason to make love simply don't compute in my brain. Is there something wrong with me? Am I shallow to place such importance on it?

It's not like I have an empty life. I own my own business and find the work rewarding and interesting. I am also a performing singer/songwriter with two bands. I have a family I'm very close to and friends I enjoy spending time with. I volunteer in my community and really enjoy the opportunities that gives me to help others. Why, then, does any hint of a problem with orgasm feel like a death knell? Why do I feel like my life would be empty and joyless without it? I once asked my husband what he would do if he lost the ablility to have sex. He said he's mourn the loss and then get on with his life. I don't know why, but his philosophical attitude floored me. I know in my head that it's true - what else could you do? But I couldn't see myself giving up. In fact, I'd probably drive myself crazy trying to find a cure and it would affect everything.

Shirlr, I totally hear what you are saying, and you're right - I don't haven't experienced something that is undoubtedly worse. I imagine that would put it in perspective and I would deal with it somehow. But like you, I'm also just sick about how little real help there is for women.

Sorry for such a long post. The bad weather is making me edgy as well.

Eva

Eva, I hope your power is back on soon. We're up and running, but lost most of our roof. Thank goodness my husband is handy, not afraid of heights, and Lowes didn't run out of shingles!

Interesting comment. I'm like your husband, if for some reason sex was no longer possible, I'd be upset but could move on and live a pretty full life. When I started having trouble with orgasm I thought the world was coming to an end. Especially after dealing with all the other, more public, problems associated with breast cancer treatment. Sex without orgasm is unthinkable for me. Just wouldn't happen. But I could probably adjust to a life without sex if I had no other option.

I think the ability to have sex and reach orgasm is something we're all proud of - sort of like being a good cook or knowing how to play tennis. It's part of who we are and one of our accomplishments in life and we measure our self-worth by our sexual ability. If you took that away, we would feel damaged and somewhat inferior to everyone else. We all like being in the "club". I guess that's why they used that "get back in the game" line in the Viagra commercial.

Just my thoughts. Stay warm!

The decline in breast cancer incidence is good news but I think the media had a field day with it before it could be fully substantiated. The nature of the data cannot even prove causality but the media jumped on it and assumed it was because of women discontinuing HT. Shame on those who were so quick to point the finger at HT !The public is getting the wrong message and throwing women into a panic over it.

Of course this explanation should be considered but not as the single, definitive justification for the decline.

Actually, this is one of many possible explanations for the decline and I think women need to know that! There are probably many, many factors involved that piece together the puzzle.

One contributing factor may be the fact that women aren't getting their mammograms. The greatest decline in mammograms occured in women ages 50 to 64. Maybe breast cancer just isn't being diagnosed because women are not being screened!

My point is that these numbers raise more questions than answers. HT may be one of many contributing factors but until we see the long-term results, we cannot jump to any conclusions.

All this really confirms is the fact that estrogen should be viewed as an individualized medication (not something for everyone). And, there needs to be more research.

<small>[ 12-22-2006, 09:13 PM: Message edited by: Moderator ]</small>

For the Red Hot Mamas' take on this important issue, visit our January e-newsletter, The Menopause Minute:
http://www.redhotmamas.org/newsletters/newsletter_200701.html#A1

New breast cancer incidence data from 2004 was released last week. The decreased rates seen in 2003 were also present in 2004. According to an April 19th, 2007 report from the New England Journal of Medicine, the sharp decline in breast cancer cases is due to national decline in use of HT. Personally, I still think it's too soon to tell. To read the NIH report, go to: http://www.nih.gov/news/pr/apr2007/nci-18a.htm

The Red Hot Mamas will report on the new findings shortly.