# Comparing Cancer Risks and Mortality between Phytopharmaceuticals and Estrogen-Progestogen Medications for Menopausal Women: A Population-Based Cohort Study

## TL;DR

This study compares cancer risks and mortality in menopausal women using phytopharmaceuticals versus hormone therapy, finding phytopharmaceuticals may offer safer long-term outcomes.

## Contribution

The study introduces population-based evidence showing phytopharmaceuticals may reduce cancer and mortality risks compared to estrogen-progestogen medications.

## Key findings

- Phytopharmaceuticals group had lower cancer and mortality risks than HRT group.
- Bupleurum and Peony Formula showed reduced cancer and mortality risks.
- Findings suggest phytopharmaceuticals may be safer alternatives to HRT.

## Abstract

We evaluated the long-term risks of overall cancer and all-cause mortality associated with five types of phytopharmaceuticals and the most commonly used estrogen-progestogen medications for the treatment of postmenopausal syndrome in women. Using data from Taiwan’s National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2018, we conducted a 1:2 matched cohort study with 12,087 eligible patients. We compared phytopharmaceuticals -only users (n = 4029, phytopharmaceuticals group) with HRT-only users (n = 8058, HRT group) with a washout period of ≥6 months. The phytopharmaceuticals group had significantly lower risks of overall cancer and all-cause mortality than the HRT group (adjusted hazard ratio [95% confidence interval]: 0.60 [0.40–0.9] and 0.40 [0.16–0.99], respectively) after over 180 days of use. Bupleurum and Peony Formula were associated with lower risks of overall cancer and all-cause mortality (aHR: 0.57 [0.36–0.92] and 0.33 [0.11–1.05], respectively). In conclusion, phytopharmaceuticals may serve as an alternative therapy to HRT for alleviating menopausal symptoms and reducing health risks, leading to more favorable long-term health outcomes. Further randomized control trials are necessary to validate the findings of this study.