Lots of recent questions about hormone therapy.  This used to be called Hormone Replacement Therapy, but these treatments don’t replace hormones to their previous level.  They are useful to treat menopausal symptoms, reduce osteoporosis and fractures.  The problem is the growing list of dangers associated with these hormones.  Lung Cancer is the newest cancer linked with hormone therapy.  Estrogen and progestin might increase risk of developing lung cancer, especially when used for 10 or more years.  It might also stimulate growth of existing lung tumors, more in older women especially smokers.   Some lung cancer tumors have hormone receptors that respond to the stimulation by hormone therapy.

Breast cancer risk increases after 3 years on estrogen plus progestins, much sooner than originally thought at 5 years based on previous studies.  This risk increases 8 cases of breast cancer per 10,000, but the risk declines after 2-3 years of stopping hormone therapy.  Risk also increases for drinking alcohol, sedentary lifestyle,

Endometrial cancer risk is 5 times higher for women on estrogen alone for more than 3 years.

Colon cancer risk was initially thought to be better on hormone therapy, but longer term studies show show it does not prevent colon cancer and the risk is the same.

Ovarian cancer risk is not changed or very small if any risk. 

Because of these risks, use for the shortest possible time and only for severe menopausal symptoms is suggested.

Links:

Quackwatch article on “Bioidentical” hormones

LEG CRAMPS

I also get a lot of questions about leg cramps, especially night cramps.  These are very difficult to manage.  First looking or restless leg syndrome which is an irresistible urge to move the legs.  It usually is worse at night, resting, and can be associated with a creepy, itchy or pulling sensation.  Short of this diagnosis, simple leg cramps are more difficult to manage.  Some medications like fluid pills, asthma or copd treatments can worsen.  Low potassium, magnesium and calcium can be associated with worsening.  What works best is variable.  Try calf stretches often and before bed, hot or cold packs depending on which helps more.  Drink some gatorade early evening to rehydrate and replace electrolytes.  Vitamin B-complex, magnesium can help and are worth a try.  There are some medications that are helpful but are muscle relaxers, anti-anxiety or anti-convulsant medications so they carry the risk of significant side effects. 

Quinine was popular treatment for many years but recent evidence shows the risk of the quinine is greater than the risk of the cramps.  It’s no longer available for prescription except for one approved version but its’s expensive at about $5 per capsule and would be an off-label use due to high risk side effects possible.