Page last updated at 23:00 GMT, Monday, 19 May 2008 00:00 UK

HRT hype 'means women miss out'

Woman receiving HRT advice
The risks and benefits of HRT can be confusing

Too many women are missing out on hormone replacement therapy because of "overhyped" safety concerns, an international group of experts warns.

Some of the concerns over HRT and heart disease and breast cancer are not justified by the clinical evidence, the International Menopause Society said.

However, cancer expert Professor Valerie Beral, of Oxford University, dismissed the research as flawed.

Fears over HRT began in 2002 after the publication of a large US study.

National guidance now states women should be prescribed the lowest dose for the shortest possible time.

The Royal College of GPs said women should discuss the pros and cons of treatment with their doctor.

Women's confidence has been shattered and prescribing by GPs has been shattered so a lot of them are going to take a lot of convincing
Dr David Sturdee, International Menopause Society

The Women's Health Initiative - a major trial looking at more than 27,000 women - was halted after finding a significant increase in the number of cardiovascular events, such as heart attack.

Higher rates of breast cancer were also found but the study did find the drug seemed to offer protection against osteoporosis.

It was estimated that the number of women using HRT fell by half after the results were published.

But later analyses of the data suggested that although older women taking HRT had a higher heart risk, women aged 50-59 years did not.

The magnitude of breast cancer risk has also been questioned as the women in the study were taking high doses of HRT.

'Misperceptions'

At a global summit held in Zurich by the International Menopause Society, experts concluded younger healthy women should have no fears about taking HRT in the first few years of menopause to relieve symptoms.

President, Dr David Sturdee said there were a lot of "misperceptions" about HRT which meant a lot of women were suffering poor quality of life.

"HRT is the most effective treatment for menopausal symptoms but press reports over the last few years have made it difficult for many women to consider its use.

"Women's confidence has been shattered and prescribing by GPs has been shattered so a lot of them are going to take a lot of convincing."

He said some women were not even being given chance to discuss the risks and benefits with their GP.

He also said the Society also took exception to guidelines which said women should be taking HRT for no more than five years.

"They should be on it for as long as they need to be on it," he added.

A spokesperson for the Royal College of Obstetricians and Gynaecologists said their advice had not changed and women should use the lowest dose which gives symptom control, for the shortest possible time.

They added: "Based on the current evidence starting HRT at the early onset of the menopause, and carrying on for a few years apparently carries little risk in healthy women."

Dr Clare Gerada, vice chair of the Royal College of GPs, said the benefits of HRT had been overhyped in the past.

"I was very pro the drugs in the 1990s but at that time I think we were being duped into thinking every woman should be on HRT.

"There is a place for HRT and we've now reached a happy medium and we're much more savvy at looking at the evidence."

But Professor Beral said the latest study had serious flaws, and quoted only a small fraction of the evidence.

She said regulatory bodies in the UK, US and Europe had examined the data on HRT, and did not come to the same conclusion.

A thorough investigation by the UK Medicines and Healthcare products Regulatory Agency (MHRA) carried out last year concluded that current guidelines advising on strict limits on the use of HRT were correct.


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