Menopause guidance is too negative about HRT, says Mccall
Broadcaster urges draft advice from Nice to take benefits of hormone treatment into account
“PATRONISING” NHS menopause guidelines are too negative about HRT, Davina Mccall has said.
The TV broadcaster, who is patron of campaign group Menopause Mandate, hit out at draft advice which says GPS should consider offering women talking therapy to treat hot flushes.
Recent years have seen a surge in women turning to hormone therapy, with many crediting the “Davina effect” after Mccall made documentaries about her own experience of the menopause.
Today Mccall and Mariella Frostrup, the broadcaster and a fellow campaigner, spoke out as the National Institute for Health and Care Excellence (Nice) closes a public consultation on draft guidelines.
The celebrities campaign on behalf of Menopause Mandate, raising awareness of the struggles many women face and the help on offer. The group said the draft guidance from Nice, issued in November, had left women feeling “gaslit”, with their needs ignored.
The campaigners also criticised the language used by Nice, which describes menopause symptoms as “bothersome” and “troublesome”, saying the guidance ignored the range of symptoms and extent to which women can suffer.
In their submission, they said: “The language used is sometimes patronising. ‘Bothersome’ and ‘troublesome’ hardly reflect the breadth of the impact symptoms can have on quality of life.”
Nice’s draft advice said GPS should consider offering cognitive behavioural therapy (CBT) to treat hot flushes – either instead of or in addition to HRT.
Previously, GPS had been told to consider talking therapy to “alleviate low mood or anxiety” that results from the menopause, but not to treat hot flushes.
The new proposals said CBT could reduce the frequency and severity of hot flushes – although they admitted to “uncertainties” about the quality of evidence to support this.
Nice stressed that the draft guidance still recommends HRT for hot flushes, only offering CBT as an extra option.
Menopause Mandate, one of the stakeholders in the consultation, proposed changes to the guidance.
The submission said: “There is far too much emphasis on the risks of HRT and not enough on the benefits. The benefits of HRT are generally considered to outweigh the risks for the majority of women and this is not reflected.”
“Although CBT has its place, it is unrealistic to think it could be offered to the entire peri and menopausal population, and it is not an alternative to HRT.”
The submission also said: “More consideration and detail needs to be given to testosterone, to lifestyle changes (that will benefit all women) and to
‘There is far too much emphasis on the risks of HRT and not enough on the benefits’
those experiencing premature or surgical menopause.” After Mccall spoke about her symptoms, the number of women prescribed HRT rose by almost one third in a year.
Last month, The Daily Telegraph revealed a postcode lottery in access to HRT, with women three times more likely to be offered treatment in some parts of the country than others.
Mccall said: “The draft guideline was unbelievably confusing, and I feel we have made amendments that would help guide doctors so they can really deliver the kind of support that peri and menopausal women need and, of course, deserve. I was especially concerned by the lack of balance in the wording around HRT.”
A spokesman for Nice said: “The draft guidance makes clear that it is important that healthcare practitioners take a personalised approach when discussing treatment options, tailored to individual circumstances.”