HRT – reversal of fortune!
Thursday, 28 April 2016
Although the menopause is a normal life event for women, its effects can be detrimental. Over the last century our life expectancy has increased hugely. This has resulted in many more women being affected by symptoms of their menopause often adversely affecting their families, work and life in general. Many women suffer in silence and do not realise how effective hormone replacement therapy (HRT) can be at dramatically improving both their symptoms and also their quality of life.
The negative publicity which followed the flawed Women’s Health Initiative (WHI) study over a decade ago has led to many women and also many doctors being concerned and anxious about the potential risks of hormone replacement therapy (HRT). This has resulted in many women needlessly suffering from menopause symptoms and also increasing their risk of osteoporosis and cardiovascular disease by not taking HRT.
The timing of taking HRT is really important regarding any risks associated with HRT and many women do not realise this. Starting HRT less than 10 years since a woman’s menopause has actually been shown to have a significant reduction in death and also a reduction in coronary heart disease.
This WHI study was undertaken to look at the risks and benefits of older women taking HRT. The women in this study were, on average, 63 years old. So their results can not be used to determine the risks with HRT for women who are under 60 years. However, the media hype around this study over a decade ago failed to inform women of this.
Numerous studies have been published since the WHI study which have confirmed so many benefits of taking HRT to women. Symptoms of the menopause such as hot flushes, mood swings, night sweats and reduced libido all improve with HRT. Bone density improves with HRT and this is so important as low bone density causes osteoporosis.
Two of the authors of this WHI study have recently published an apology for this misinterpretation of the study in the New England Journal Medicine.1 They have admitted that this misunderstanding has been the cause for many women not taking HRT and thereby not benefiting from it. Hopefully this will reassure many women regarding the safety of HRT.
For the majority of symptomatic menopausal women under the age of 60 years, the benefits of HRT outweigh the risks. Sadly, many women still do not realise this.
- Manson JE, Kaunitz A. Menopause management: getting clinical care back on track. N Engl J Med 2016;374:803-6