Menopause can seem like a scary time for some women.

When we see menopause portrayed in the media or popular culture, such as in the recent movie Sex and the City 2, it's often in a negative light with women depicted as slaves to their hormones.

It's important to remember that menopause is an individual experience and not all women will experience menopause symptoms. At the same time a woman goes through menopause there may be other things going on in her life, such as changing family relationships and / or work roles as well as new experiences taking place.

A study by Swedish researchers published in the American Journal of Clinical Nutrition (AJCN) this week reported that multivitamin use was associated with an increased risk of breast cancer. Understandably, this claim generated a lot of media attention and concern among the general population.

The observational study of over 35,000 Swedish women aged 49-83 years reported a small increase in breast cancer risk amongst women who took multivitamin supplements. Compared to the non-multivitamin users, this increase equates to about five extra cases of breast cancer per 1000 women over 10 years. Interestingly, the study showed a slight decrease in risk for those women who took calcium supplements (about seven less cases of breast cancer per 1000 women over 10 years).

According to Jean Hailes endocrinologist Prof Henry Burger, "It is important to note that those women who used multivitamin supplements also had a higher rate of breast cancer risk factors such as benign breast disease, nulliparity (never had children), use of oral contraceptive pill or hormone replacement therapy and non-smokers. While some previous studies have shown a relationship between nutritional supplements and cancer, other studies have found no effect or in some cases, decreased rates. The same issue of AJCN in which this study is published also includes a study that reports a protective effect of vitamin D supplementation. In addition, a recent study published by the American Association for Cancer Research showed that multivitamins reduce the risk of breast cancer by 30 per cent and calcium reduces this risk by 40 per cent."

Comments from researchers at the Jean Hailes Foundation for Women's Health - September 21, 2009

Study summary

Research based on the original Women's Health Initiative (WHI) study has just been published in the Lancet 2009; September 20, entitled "Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial. This research has noted that among women aged 60 years and over, there is a small increased risk of death from one type of lung cancer, (5 additional deaths per 10,000 women over 60 started on HRT per year) but no increased risk of death overall for women taking HRT compared to those not on HRT. The study did not show an increased number or rate of lung cancers. Importantly, these observations were not noted in women 50-59 years of age who make up the large majority of women starting HRT for menopausal symptom relief in Australia.  In women over 60 years who are at high risk of lung cancer (ex or current smokers), this should be taken into account when weighing up the risks and benefits of beginning HRT, an uncommon practice in that age group.

The International Menopause Society, at their latest Congress, confirmed that for women aged 50 to 59, HRT remains the first line and most effective treatment for menopausal symptoms. For women in this age group there is no significant increase in risk in using HRT - in fact the benefits outweigh the risks. This recent study data does not influence that conclusion with no observed impact on women aged 50-59 years.

The Lancet has issued a press release on HRT use and lung cancer (Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial, by Chlebowski RT, et al.).

The International Menopause Society has issued a statement, which was written by Professor Amos Pines on behalf of the  IMS (reproduced with permission).