Why taking Mounjaro with HRT could raise risk of womb cancer - and those with obesity or diabetes are particularly in danger: Special report by JULIE COOK
Share this @internewscast.com

Women taking oral hormone replacement therapy (HRT) are being advised to talk to their doctor if they also start using the weight-loss jab Mounjaro, amid concerns they could be at a higher risk of womb cancer.

Meanwhile, there are fears that women getting hold of Mounjaro online – rather than through their GP – will be unaware of the potential risk.

HRT provides oestrogen to ease menopause symptoms such as hot flushes, low mood and reduced sex drive.

Because oestrogen thickens the lining of the womb, which can increase the risk of it becoming cancerous, it is combined with progesterone, or a progestogen (a synthetic version of progesterone) in HRT to help keep the lining thin.

Many women take oestrogen in the form of a rub-on gel or skin patch – rather than orally – but progestogen in the form of a tablet which has to be absorbed into the bloodstream through the lining of the stomach.

The worry is that a reduction in the absorption of oral progesterone or progestogen as a result of taking Mounjaro could increase the risk of cancer of the womb.

And there is a different risk for women taking the oral contraceptive pill and the weight-loss jabs: an unplanned pregnancy.

The new obesity-fighting drugs contain semaglutide (brand names Wegovy and Ozempic) or tirzepatide (Mounjaro) – these work by slowing digestion (‘gastric emptying’), and can cause gastric symptoms such as nausea and vomiting, which may reduce the absorption of oral medication.

Doctors should consider raising a woman’s dose of oral progestogen when she starts on Mounjaro, says Professor Annice Mukherjee, a consultant endocrinologist

Doctors should consider raising a woman’s dose of oral progestogen when she starts on Mounjaro, says Professor Annice Mukherjee, a consultant endocrinologist

New guidelines from the British Menopause Society warn Mounjaro could interfere with absorption of oral forms of HRT

New guidelines from the British Menopause Society warn Mounjaro could interfere with absorption of oral forms of HRT

Now new guidelines from the British Menopause Society (BMS) warn Mounjaro could interfere with absorption of oral forms of HRT.

While the cancer risk is ‘theoretical’ only, doctors should consider upping a woman’s dose of oral progestogen when she first starts on Mounjaro, says Professor Annice Mukherjee, a consultant endocrinologist at Spire Healthcare in Manchester, who helped write the new guidelines.

This is when the effect on the absorption of oral pills is greatest (according to the Mounjaro patient leaflet).

The progestogen dose should then increase temporarily each time the dose of the weight-loss drug increases – to compensate for the additional effect on absorption. The BMS guidelines are aimed at women who take oral progestogen alongside oestrogen in gel or patch form.

(Among those on combined oral contraceptives, absorption of both oestrogen and progestogen are reduced and women who’ve had a hysterectomy are not included in the new guidelines, as they take only oestrogen.)

Professor Mukherjee told Good Health that the reduction of progestogen ‘is a particular issue for women living with obesity and diabetes [the conditions the new jabs are designed to treat] as they already have an increased risk of womb thickening and cancer’.

‘Patients suitable for Mounjaro should generally be offered transdermal oestrogen [eg gels or patches], which is considered mostly safe in women with diabetes and obesity, and not oral oestrogen, which can increase risks of blood clots.’

An alternative to increasing the dose of oral progesterone is to switch to a non-oral form of progesterone, such as the Mirena coil implant, or use a combined oestrogen-progestogen patch, says Dr Alice Scott, a menopause specialist at Essex Private Doctors.

Another potential consequence of reduced progestogen absorption is unexpected bleeding and spotting. Dr Scott, who has treated patients with the problem at her clinic, says she’s seen this in women who’ve bought slimming injections online without proper medical guidance.

‘My concern is that with it being so easy to get these medications online, women are not having adequate consultations before obtaining them,’ she says. ‘This means that advice about the effect of these medications on other oral drugs is not given.

‘There’s evidence that these weight-loss medications generally [ie not only Mounjaro] may also reduce the effectiveness of oral contraceptive pills which could increase the risk of pregnancy, so it is important for women using these to discuss this with their doctor, too.

‘The problem is many people do not disclose to their doctors that they are on Mounjaro or other weight-loss jabs, so it is important that healthcare providers directly ask patients at their medication reviews.’

Novo Nordisk, which makes Ozempic and Wegovy, recommends that the drugs are taken under medical supervision.

A spokesperson added: ‘No clinical trials have specifically looked at how HRTs and semaglutide interact. In other pharmacology trials, semaglutide did not affect the absorption of oral medications to any clinically relevant degree.’

But they added: ‘As semaglutide causes a delay of gastric emptying it may potentially impact the absorption of oral medication taken alongside it, as such, caution should be exercised when taking oral medications alongside semaglutide and should be discussed with your healthcare professional.’

Mounjaro manufacturer Eli Lilly said information given to healthcare professionals explains that ‘tirzepatide delays gastric emptying and thereby has the potential to impact the rate of absorption of concomitantly administered oral medicinal products’.

‘This effect is most pronounced at the time of tirzepatide treatment initiation,’ added a spokesman.

‘Patients should consult their doctor or other healthcare professional regarding the right treatment options or to report any side-effects they may be experiencing.’

Share this @internewscast.com
You May Also Like

Mom Shares Overlooked Symptom That Led to Shocking Bowel Cancer Diagnosis

A mum has revealed the unexplained symptom she experienced for months before…

Medical Experts Alert: Worrisome Trend Endangers Millions in the U.S. with Aggressive Cancer Risks

A fringe theory is catching fire online, and health experts are sounding…

Daily Bite of Food Consumed by 75 Million Americans Linked to Cancer

Experts are sounding the alarm over a common food that – in…

Cautionary Alert: Popular Supplement Linked to Potential Organ Damage and Nerve Issues

Britons taking a host of over-the-counter supplements are risking organ damage  and…

“I Faced Death Seven Times and Didn’t See a Bright Light or Tunnel”

Shona Hirons experienced nothing when she nearly died (Image: Jam Press) A…

Avoid Storing Toothbrushes on the Sink: An Activity That Allows Bacteria to Linger

Many people believe their bathroom is clean as long as it looks…

Affordable yet contentious supplement outperforms dementia, taken by millions

Apart from helping you improve muscle growth, your protein powder may also…

Optometrists Recommend Popular Diet Change to Enhance Vision

Eye doctors have urged people to start consuming specific foods if they…

Scientists Identify Eight Daily Habits That Boost Heart Health and Reduce Mortality Risk

A recent study has discovered that scoring low on Life’s Essential 8…

Authorities Extend Beach Closures for July 4th Over Dangerous Bacteria Concerns

Clear skies and warm waters may tempt many to head to the…

For Optimal Health Benefits, Drink Coffee at This Specific Time

Whether it’s the flavour, the ritual, or the energising boost, coffee is…

Experts Suggest Many Diagnosed with ADHD Could Actually Have a Different Common Disorder

A major new analysis has fueled concerns over the accuracy of tests…