Confused about HRT? read on!

May 20 2008

As if women are not confused enough about the pros and cons of hormone replacement therapy (HRT), an international group of experts now say safety issues regarding HRT have been "over hyped".

A review from the first global summit on menopause-related issues aims to set the record straight on the numerous health scares surrounding the use of HRT and says HRT does not raise the risk of heart disease for all women and its impact on breast cancer is 'minimal'.

An international panel of 40 experts say the health risks have been greatly exaggerated and for many women late motherhood, obesity, drinking alcohol and eating lots of fatty foods push up the chances of developing breast cancer to a level similar or less than that of taking HRT.

According to the review, although combined forms of HRT containing oestrogen and progestogen may slightly increase the chances of breast cancer, the effect is dwarfed by other risk factors and some of the concerns over HRT and heart disease and breast cancer are not justified by the clinical evidence.

The International Menopause Society says because of the exaggerated safety concerns, many women are missing out on the benefits of HRT.

The risks and benefits of HRT appear to have confused the medical profession as much as they have confused women with experts on a regular basis contradicting each other.

It was in 2002 that worries about HRT first surfaced when a large study carried out in the States, the 'Women's Health Initiative', concluded that HRT considerably raised the risk of a heart attack and breast cancer ; the trial, involving more than 27,000 women was immediately stopped.

That study did however find that HRT appeared to offer protection against osteoporosis.

Current advice says women should be prescribed the lowest dose for the shortest possible time and should discuss the pros and cons of treatment with their doctor.

But for many women and doctors, confidence has been destroyed and the number of women using HRT has fallen significantly.

Since 2002 the data has been questioned and suggestions made that although older women taking HRT had a higher heart risk, women aged 50-59 years did not and the breast cancer risk was influenced by the high doses of HRT being prescribed.

At a global summit held in Zurich by the International Menopause Society it was reported that HRT remains the most effective treatment for menopausal symptoms but a bad press over the last few years has deterred many women from considering it.

Experts now say younger healthy women should have no fears about taking HRT in the first few years of menopause to relieve symptoms and the International Menopause Society says "misperceptions" about HRT meant many women were suffering poor quality of life.

The Society has also taken exception to guidelines which state that women should take HRT for no more than five years and says they should be on it for as long as they need to be on it.

Dr. David Sturdee, one of the authors of the review and president-elect of the International Menopause Society, says doctors should be prescribing HRT more freely and the five-year 'limit' should be lifted.

The summit experts concluded that combination oestrogen and progestogen HRT did not raise the risk of heart disease in healthy women aged 50 to 59, and that oestrogen-only HRT actually decreased heart disease risk and while oestrogen and progestogen HRT did slightly increase the risk of breast cancer the effect was minimal compared with other risk factors.

They found that HRT effectively maintained bone density in women aged 50 to 59 and could help prevent the brittle bone disease osteoporosis and did not impair the thinking processes of women aged 50 to 59 and may even delay the age-related blunting of mental abilities.

The findings were presented this week at the World Congress on the Menopause in Madrid.