With so much historical controversy around treatment for symptoms of the menopause, with over fifty treatment options and confusion over the role of bio-identical hormones how can a woman get the best impartial specialist advice on HRT?
Back in 2002 and 2003, the results from two studies raised concerns regarding the safety of HRT. According to Women's Health Concern, "these safety concerns revolved around two main issues:
- that extended use of HRT may increase the risk of breast cancer and
- use of HRT may increase the risk of heart disease.
The results of the studies received wide publicity, creating panic amongst some users and new guidance for doctors on prescribing."
Getting the right HRT
Following publication of these papers the UK regulatory authorities issued a range of restrictions and there is still confusion and uncertainty amongst both doctors and HRT users. The number of women taking HRT fell by over 60%, and this figure has not changed meaning that for the past 10 years, many women have not received the opportunity of improved quality of life during their menopausal years.
However, Professor John Studd and his team of specialist gynaecologists, including the British Menopause Society have consistently pointed out the shortfalls in these studies. Professor Studd says, "not least of all because in 2002 from a large American study which selected an inappropriate group of patients (they were too old) and gave them the wrong type of HRT (too high a dose of oestrogen along with continuous progestogen)."
The stance adopted by Professor Studd and his team has subsequently been proven correct and demonstrated following results from more recent studies. Subsequent publication of the full WHI results showed the apparent increased risk for breast cancer was only found in those who had taken HRT before entering the study. Further analyses from both the combined HRT and oestrogen alone WHI studies have shown no increase in heart disease in women starting HRT within 10 years of the menopause.
Interestingly, in comparison to the previous media scare, the about-turn and retraction of some of the previous findings has received little publicity in the media. A new study from Denmark reported in 2012 has demonstrated that healthy women taking combined HRT for 10 years immediately after the menopause had a reduced risk of heart disease.
To a certain extent professional attitudes have now shifted back in favour of HRT as a treatment option, provided that the risks and benefits are fully assessed and agreed in each individual case. HRT provides major health benefits that may include prevention of bone weakening (osteoporosis) and the hormone-related depression often associated with menopause. However, anyone seeking the best possible advice on the type of HRT treatment that might be appropriate for them should ideally ensure that their specialist is a gynaecologist specialising in menopause, is a member of the British Menopause Society and are up-to-date on the latest findings and treatments.
Women's Health Concern advises that if your family doctor does not have sufficient knowledge of the current situation concerning the benefits and risks of HRT then it is your right to request advice from a local Menopause clinic or a specialist with known expertise in menopausal health such as Dr Beverly Benster.
The time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle, and her periods ceaseFull medical glossary