Over the last three days, participants in the EMAS 2017 congress including myself have been treated to a number of engaging sessions on a variety of different topics related to women’s health. We hope that you have enjoyed coverage of the presentations here on an educational women’s health blog, but before we pack our laptop away and fly home from Amsterdam, we wanted to share one last conference post summarising all of our key takeaways from the event.
What are our 5 key takeaways from the past 3 days?
- The suggestion that women should only take MHT for up to 5 years should no longer apply. Data shows taking MHT for longer can actually lower mortality rate. The IMS are now suggesting there should no longer be a maximum age stop for MHT. They believe women should take MHT as long as they are experiencing treatment benefit and risks have been evaluated. Although current practice can be to stop MHT every 1-2 years, IMS believe evidence shows this is not necessary but instead importance should be placed on having a yearly evaluation with patients about whether treatment should be continued. Experience is showing us that changes in perception of MHT may be needed from the regulators!
- The relationship between breast cancer risk and MHT is much more complicated than the WHI study initially suggested.
- Estrogen only MHT has been proven not to increase breast cancer risk
- Research has also shown that the use of MHT in healthy BRCA1 and BRCA2 carriers is not associated with an increased risk of breast, ovarian or endometrial cancer
- Although some investigations have shown a temporal association between the reduction in MHT use and reduction in breast cancer, this association is not universal as portrayed in the media. In addition no temporal association has been demonstrated between the increase in MHT use and an increase in breast cancer risk.
- We know that age is a huge risk factor for CHD and MHT can be beneficial in the prevention of coronary events in younger women with early initiation reaping the largest benefits. For older women, MHT does not shown any cardiac benefit or pose a CHD risk and can continue to be provided, with data showing initiating a low dose can ensure cardiovascular safety in elderly women. Latest data from the Finnish registry also suggests that stopping MHT may be dangerous to CVD risk, but that the risk declines one year after treatment has ended. For this reason it is suggested MHT should be tapered rather than stopped abruptly. This contradicts data from the PERFECT study which suggests women can experience CVD benefits up to years after finishing MHT treatment- more data is needed!
- Body changes can occur much earlier than expected, with latest literature showing that childhood obesity in girls as young as 6-14 can lead to a higher risk of endometrial cancer later in life. The importance of advising patients of all ages about the correct lifestyle choices was echoed throughout the conference, difficult conversations about weight, exercise, activity, smoking and drinking need to be had, it’s not just about medical treatment!
- Literature has shown that musculoskeletal pain increases during and after perimenopause. Those who are in perimenopause will have an increased risk for osteoarthritis (particularly hand) and rheumatoid arthritis. We still need more data to be collected in order to see if MHT can be beneficial for osteoarthritis as we await studies in well-defined populations of symptomatic OA patients, but current data should be considered when evaluation the best source of treatment for perimenopausal women with joint pain.
So that’s it! It’s been a jam-packed conference and I hope you enjoyed it as much as I have. The medDigital team would really value your feedback is. If you can spare the time, leave a comment below to let us know what you think or fill in our feedback form: https://www.surveymonkey.co.uk/r/FJY222J
Safe travels home!