NOW DOCTORS SAY HRT IS SAFE

Major study backs hormone replacement therapy and scotches health fears that deterred thousands of women from using drug

TAKING hormone replacement therapy to cope with the menopause is safe, a major study has concluded. Doctors l ast night said that women can finally take HRT with confidence, after years of scares that the treatment may cause serious side-effects.

At least one in four British women who avoid the medication does so because of concerns about health consequences, according to studies.

The number of Scots using the treatment dropped by more than three-quarters in only six years.

The menopause, which commonly strikes women in their late 40s and early 50s, can cause depression, hot flushes, headaches and night sweats. Long term, it can also cause bone disease and memory loss.

HRT tackles the symptoms by providing oestrogen as the body stops producing it.

But many women go without the treatment because their doctors are reluctant to prescribe it and, instead, they are left to deal with the symptoms unaided. The numbers taking HRT plummeted after scares in the early 2000s raised fears of side-effects.

But the new research, which will be presented today at the American Society for Reproductive Medicine conference in Baltimore, suggests that the risk of health impacts has been overstated.

Scientists at New York University found that women who took HRT for up to 25

years were no more likely to develop problems such as diabetes, heart disease or breast cancer than other women, even after a decade of follow-up checks.

Lead author Dr Lila Nachtigall said: ‘We found women taking HRT over a long period of time to be in very good health. For a woman who needs HRT, the benefits outweigh the risks.’

Her team analysed women who had taken HRT for an average of 14 years and compared them to a second group of women who had gone through the menopause but had not taken the drugs.

They carried out full-body scans using X-rays every year for a decade on 80 women who had taken HRT and 56 menopausal women who had not.

They assessed their body fat and overall body composition, looked at the strength of their bones and monitored them for signs of heart disease, diabetes, ovarian cancer and breast cancer.

This found women who took HRT were no less healthy on any of the assessments than the unmedicated group.

An estimated one million British women currently take HRT, but the numbers have halved since the early 2000s.

In Scotland, prescriptions have reportedly plummeted from around 70,000 in

‘This will provide reassurance’

the last quarter of 2002 to about 16,000 in the last quarter of 2008 – the latest year for which figures are available.

A study by Scottish experts published earlier this year found there has been ‘negativity and confusion’ surrounding HRT since the millennium.

The analysis, published in the journal Post Reproductive Health, states for the majority of women, particularly the under- 60s, the benefits outweigh the risks.

However, women were still put off taking it, with half of the almost 1,500 women studied also experiencing ‘resistance’ from their GP in offering it.

Doctors have been reluctant to prescribe the drug since two studies in 2002 and 2003 raised fears about the risk of breast cancer and heart disease.

But expert analysis has since concluded those studies were flawed because the doses used in them were too high, and the risks were l argely f ound i n older women who took HRT many years past the menopause, for whom it was never intended.

Nonetheless, many women are given antidepressants to cope with the mood swings and anxiety that often accompany the menopause. About 85 per cent of British women going through the menopause do not take the drugs, polling data also pub- lished today has found. A total of 27 per cent of these women who avoid HRT do so because they are concerned about the health effects, according to the study of 1,000 British women commissioned by medical firm Mylan.

Professor Grant Cumming, from Dr Gray’s Hospital in Elgin, Moray, who led the Scots study of women from 33 countries, said: ‘While the latest research must be treated with caution, this will provide reassurance to women.

‘Women were scared to take HRT after previous studies, despite their flaws. But with new research, the pendulum is starting to swing the other way.’

NHS watchdog Nice, which operates south of the Border, is due to publish new advice about HRT next month, and is expected to order GPs to significantly expand the number of women they consider for the drugs.

Dr Sarah Gray, a Cornwall GP and women’s health specialist, said: ‘Women are currently reluctant to seek help for their daily symptoms due to confusion over the role and safety of HRT. This means many may be unnecessarily experiencing symptoms that are impairing their quality of life on a daily basis.’

Dr Nick Panay, consultant gynaecologist at Chelsea and Westminster Hospitals, said that the tide of medical opinion is turning in favour of HRT.

‘We believe that the right HRT preparation, in the right woman, has low overall risks and has significant benefits,’ he said.

‘Too many women are being denied hormone therapy that might benefit from it. Where there are risk factors, it is about properly risk assessing women on an individual basis.’

Professor John Studd, consultant gynaecologist at the London PMS and Menopause Clinic, said: ‘The problem is that most GPs are frightened of HRT – they will have learned as medical students that it is linked to health risks, and it sticks in their minds.

‘But those studies that were replicated in the textbooks were worthless. They collected the data all wrong.’

Professor Richard Paulson, vice-president of the American Society for Reproductive Medicine, said: ‘This information is very reassuring to women who need to take hormone therapy to treat menopausal symptoms, s uch as hot f l ushes a nd insomnia.’

An Oxford study of 9,000 people published in March suggested certain health problems are actually reduced in those using HRT. The paper found that in women under 60 – or those who started HRT within ten years of the menopause – there was a 30 per cent drop in deaths from any cause and a 48 per cent lower risk of coronary heart disease.