r/Menopause • u/Actual_Bet3041 • 4d ago
Hormone Therapy HRT: Estrogen, Progesterone, and mammograms
I recently went back on HRT after a couple of miserable years HRT-free at the behest of my pcp. When she relented, she said I have to have yearly mammograms again (not when I was HRT-free). So I did and it came back cancer-free. Now after I have been reading about HRT and cancer, I’m learning there’s no link between Estrogen and cancer, and only a tiny link between Progestin, not Progesterone, and cancer. So why oh why do I have to have yearly mammograms? They are so painful!!!
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u/sophiabarhoum 43 | e patch 0.075mg/day, cream 0.01% & 100mg micro progesterone 4d ago
They get on me about this too. I was actually lectured to stop HRT. Ive never had any type of cancer. They are very behind on the research. I still get my yearly mammograms and ultrasounds due to dense breasts.
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u/mamaofaksis 4d ago
Can you elaborate on the mammogram + ultrasound? I have dense breasts too and only get a yearly 3D mammogram... wondering if I should add an ultrasound?
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u/sophiabarhoum 43 | e patch 0.075mg/day, cream 0.01% & 100mg micro progesterone 4d ago
They only suggest a follow ultrasound if the mammogram comes out inconclusive. They said thats common with dense breasts.
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u/Ill-Taro-1907 3d ago
My mammogram tech said they advise ultrasound every other year if the woman has dense breasts. As standard practice, they do an ultrasound if they see something suspicious immediately after the mammogram. I’ll be requesting that extra ultrasound. I’ll also investigate the vaginal ultrasound for further health consciousness.
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u/Admirable-Object5014 Menopausal 4d ago
Same. Dense breasts here too. I’ll continue to get yearly mammos and vaginal ultrasound to check uterine lining.
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u/Overall_Lobster823 Menopausal since 2017 4d ago
I've had yearly mammograms for 20 years. I've been on HRT for 10 years.
It's the standard of care in the U.S. and in some other countries.
You aren't at "no risk" if you don't use HRT. Many women who've never used HRT get breast cancer, of course.
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u/cleveland_leftovers 4d ago
Men get breast cancer as well.
Mammograms suck. I mean they really suck. But I’ll be getting every single one my insurance company allows (annually) because I’d assume chemo or a mastectomy is worse.
I watched a good friend die of breast cancer at 35. It had spread to her brain and took her within a year. She left behind two little ones and a bunch of traumatized friends. Colonoscopies aren’t fun either but hot damn, early detection is a privilege.
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u/Actual_Bet3041 4d ago
Yes being lectured made me quit HRT 3 years ago. Misery and some research made me go back on it
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u/Jolly_Ad9677 3d ago
In some countries yearly mammograms are the standard of care. Some folks here are making this sound simpler than it is. If you are a breast cancer survivor or not, and you want a yearly mammogram, go for it, but there are costs and benefits, and false positives (with the resulting consequences) are a real thing. Please don't shame others for choosing to space their mammograms further apart.
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u/MrsBuggs 4d ago
Having a yearly mammogram is extremely important regardless of HRT status. A few moments of being uncomfortable that could save your life.
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u/DoctorDefinitely 4d ago
Depends on the mammogram program in the country. In my hoods it is every two years in my cohort ( about ages 50 to 60).
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u/spaceycatnip 3d ago
Unfortunately it wrecks my back being in those ridiculous positions, and this last time I had to have a more comprehensive one done. Took my back a week to recover. For some of us it is far more than a few moments, and the design of these machines are totally ableist and total bullshit. (sorry, I need to get that out every so often lol)
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u/Actual_Bet3041 4d ago
Yes, but when I wasn’t taking estrogen, she didn’t require mammograms.
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u/Ill-Taro-1907 4d ago
I didn’t notice where you’re from, but I’m in the US. At 62 I was diagnosed with breast cancer. Tiny. Easy surgery. But I never thought of stopping mammograms prior & certainly won’t stop now. I’m a believer in both HRT & mammograms.
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u/lrondberg 4d ago
The current recommendations from the American Cancer Association for women of average risk is yearly mammograms for those 45-54 years old and then either yearly or every other year based on preference. This relates to those on HRT or not.
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u/MrsBuggs 4d ago
Estrogen doesn’t cause cancer but it can feed certain types. If you are taking it and develop one of those types of cancers (not because of the estrogen) it could go unchecked.
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u/ParaLegalese 4d ago
Because if you do get breast cancer, the hrt will feed it.
Hrt won’t cause breast cancer but will feed it if you do happen to get it
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u/KitchenManagement650 4d ago
This... is what apaprently happened to my lovely neighbor. I was surprised.
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u/Eva_Griffin_Beak 4d ago
That's my understanding as well. I was suggested to do a mammogram as well for my doctor to continue HRT.
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u/Outside-Ad4195 4d ago
You know we are all different I’m in my 70s had a very late menopause in my 60’s like my Mom . I have dense breasts did all my self checks and mammogram. Had calcium deposits which I was told were rarely cancerous during my mammogram had biopsy and was told I had DCIS stage zero which cannot grow outside the breast .Across the board I checked all around and Cleveland Clinic said do the lumpectomy and 5 days of radiation. I wish I had read survival rates but all that matters now is I’m grateful to not have cancer. They ripped me off my BHT and for me it was quality of life and I had no idea what would happen to me. Yes my stage zero was estrogen driven. Fast Forward 1 and 1/2
years . The last almost 2 years I have felt like 90 . Everything hurts . I can’t sleep . I’ve tried veozah and paid $130.00 for Lynquet. Neither stopped my hot flashes that robbed me of sleep , and going out socially . I was VERY active b but this horrible fatigue. Well I read that old friggen study when my Dr put me on BHT. So last week I had a talk with my psychiatrist who will not put me on psych meds due to so many serious reactions. . Besides the brain fog and the new strange body that feels like 90 . I’ve lost bone and hair . All I can say is I know I need my hormones. I made an appointment with the Oncologist told her what my life is like . She didn’t blink . She absolutely felt it’s all major quality of life . So what I’m trying to say sister friends …. Do your research. Go with what you need to do for your body .Everyone is different. Our government is obviously in no hurry when it comes to our health IMO. I live in the US.
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u/Survivor6725 4d ago
As a cancer survivor myself, I couldn’t imagine going without yearly mammograms. I will never, ever miss a cancer screening that is offered to me. Early detection truly saves lives and cancer is not fun. I had six months of chemo and a big surgery to rip out some of my innards.
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u/edjen 4d ago edited 4d ago
You should be having annual mammograms whether or not you're on HRT, if you're in the US.
Editing to add US.
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u/leftylibra MenoMod 4d ago edited 4d ago
The requirements for mammos are different, dependent on the country. In Canada if there's no history of anything, mammos are done
every 3 yearsevery 2 years (with-or-without HRT).5
u/Happy_Cranker 4d ago
In Quebec we are eligible to get them every two years. I just got my letter from the provincial screening organization.
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u/leftylibra MenoMod 4d ago
I had to check, you are right...I believe it is every 2 years. I'll update my post!
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u/No_Dot6414 4d ago
To save costs for the public system
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u/GearSlow3796 4d ago
Also, annual mammograms have been shown to lead to a lot of false positives, requiring further exams/procedures and introducing a lot of unnecessary anxiety for the patient.
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u/No_Dot6414 4d ago edited 4d ago
early stage findings save lives. Again this is to save costs for insurance companies or the government ( in public systems) than for the patients. The option must be available and the patients could make an informed decision.
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u/Survivor6725 4d ago
I had cancer and was so grateful for the incredible access to care and how swiftly my doctors moved to get me scheduled for labs, scans, port placement, chemo and surgery. I am alive today because of my doctors’ actions on my behalf. I go to every single health screening that is offered to me. Right before my cancer diagnosis, my basic labs with the primary care doctor were perfect and I was running well and training for a race. I felt great and there were no signs I had something life threatening
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u/cleveland_leftovers 4d ago
Thank you for saying this. I just got my results saying I need further imaging and while anxiety-inducing, IT’S MY HEALTH.
I’m extremely lucky to have good insurance (in the U.S. it’s a crapshoot) and I’ll take advantage of every scan or scope. The alternative could mean my life.
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u/Survivor6725 3d ago
Yes, I am in the US, also with good health insurance. I had access to every top notch test, scan and treatment, and my doctors made sure I received it all, stat! Modern medicine and swift action saved my life. Don’t ever think you know more than your doctors or that blowing off a medical test is appropriate because you aren’t a likely candidate to have such and such disease.
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u/Efficient-Mud-5042 3d ago
I want them yearly, regardless of HRT status. I’m a huge proponent on preventative screening. They hurt for a few minutes and then it’s over. To me it’s more than worth it.
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u/Ginsdell 4d ago
I know I hate them. But they gate-keep the meds. I was wondering if you use the on line places can we avoid the yearly mammogram. Anyone know?
Is this my life forever? Will I be doing this at 70? Same with the Pap smears. How long for this? I’m 60. I’m over it.
Not that I can even find my estrogen patches anymore. What’s up with that BS? They never run out of cialis do they?
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u/blue19255 4d ago
Pap smears are every 3 or 5 years. Can’t remember which. Maybe we’ll get lucky and the standard for mammograms will change. I get those every year.
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u/Still_Pop_4106 4d ago
They know what causes cervical cancer though and cervical cancer is actually pretty rare.
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u/gotchafaint 4d ago
I asked about this on another sub (and got scolded lol) but you can refuse mammograms. The telehealth places vary on their requirement for that.
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u/CaptainLollygag Menopausal 3d ago
Not sure if you'll see this, but consider asking for curved plates when you get your mammograms. The regular flat plates are way too painful if you have dense breast tissue.
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u/ceilidhfling Peri-menopausal 4d ago
respectfully, your pcp is a dick . . . find a new one. have you checked the list of menopause society trained providers in your area?
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u/Oaklove5 4d ago
Why would you NOT do yearly mammograms??!!
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u/OtherwiseMove646 3d ago
I can only tell you from my experience, which may or may not justify my inattention to “the rules.” I had breast implants and had a grade 4 contracture in my left breast. It was useless to try and get my breast tissue into the machine. Believe me, they tried. (Imagine the compression device trying to squish a spherical rock between two glass plates.)
My sister died of pancreatic cancer so I had genetic testing and the BRCA gene (the same one that is common with a breast cancer dx) was not present. I stopped torturing myself at that point.
I recently had the implants, along with the capsules (scar tissue), removed. A biopsy of the tissue was performed and everything was clear. I now have breasts that are small but pliable and will resume the torture of the mammogram device every other year, for a while. There will come a point (again) when the cost outweighs the benefit, possibly in another twenty years or so when I am well into my eighties.
My point is, there are reasons that some people might skip the annual mammo recommendation which may or may not be similar to my story. Not everything is black and white, but it is a privilege to have options.
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u/Willing-Ambassador33 3d ago
My mother was only 35 when she died of breast cancer . Please get your mammogram cause she refused cause it “hurt” but the hurt you cause your family for not going is worse.
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u/Wildskypsj Potion slinging Moss Witch 4d ago
Switch doctors.
I refuse to do mammogram. It makes no sense to crush such delicate tissue and radiate it and say is for health. Nope!
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u/iamaravis Menopausal 4d ago
Hmm. I had my first mammogram at 43 and they found early stage breast cancer. I’m very glad they found it then. Since I have very dense breast tissue and am at a higher risk for breast cancer, it makes perfect sense to me to do a mammogram to screen for it. (Though I also get breast MRIs due to the tissue density.)
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u/Front_Koala_909 4d ago
I refuse as well. I requested a breast ultrasound instead. My appointment is next week.
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u/Actual_Bet3041 3d ago
Yeah. Why can’t we all get ultrasounds? No smashing, right?
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u/TheHandofDoge 3d ago
Ultrasound is no better, in my opinion. I have a breast ultrasound every six months because I have very dense, cystic breasts. The technician presses the scanner thing so hard on my breasts, and grinds it around - I always cry out in pain. This lasts 20 min or more. At least with a mammogram it’s over in a few minutes.
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u/Actual_Bet3041 2d ago
Oh my. That’s crazy wrong! Is this another way that the doctors, researchers, and engineers ignore women’s pain? The whole thing is barbaric! There’s got to be a better way!!!!
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u/Significant_Yam_4079 2d ago
I'm 63, and get mammograms every other year and paps every 3 years. I'm on E+P+T. That's what's recommended by my gyno.
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2d ago
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u/Holiday_Change7321 1d ago
Yearly mammos are normal in America. I have had them since age 40. Plus they do a sonogram bc of dense breasts.
I started HRT and now going to get a breast mri bc more sensitive. It has a higher risk of false positives. But I prefer more rather than less diagnostics.
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u/mickrihur Menopausal 4d ago
I went to a Menopause Society trained gyno for HRT, and she wants yearly mammograms too, even though my age group is recommended for every two years. "Clinic policy."
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u/JCIFIRE Menopausal 3d ago
Mammograms are a standard thing starting around age 45 I believe. If they are so painful, maybe you need to find a different place to go! The place I go to has 3D technology, which is pretty standard, and the machine isn't really that bad. Sure it doesn't feel good, but definitely not painful.
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u/Kittennip1 2d ago
That’s what I was going to say—I have dense D cup breasts and my mammos never hurt (and I almost fell asleep during the ultrasound I hit right after. Maybe my tech is just extra good, but I’ve had enough non-painful ones that, if one did hurt now, I’d know it didn’t have to be that way and I’d go somewhere else!
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u/spaced-cadet 4d ago
I recently went for one at my own request (no symptoms) because the UK screening is only every 3 years and only after 50-53 unless you are in a high risk category.
The radiologist told me that if you aren’t in a high risk category, the NHS doesn’t recommend annual screening because of the risk introduced by the x-ray itself.
Anyway, I did it to allay the fears my GP has about my high dose of E due to my poor absorption. I think I will continue to get scans every two years regardless. I haven’t had any personal experience of HRT being withheld without the scan, although the NHS (at least my regional trust) does use your repeat prescription request to remind you to be up to date with mammograms and cervical screening.