Experts issue fresh HRT advice




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Experts issue fresh HRT advice

BBC News,

October 8, 2003

Hormone replacement therapy experts say that the treatment can help many women - but say they should be aware that the treatment could increase cancer risk.

The specialists, meeting at a HRT conference in Edinburgh , are to issue a "consensus statement" on safety.

Professor David Purdie, who helped write the statement, said that HRT did help women with menopausal symptoms, but was not a "lifestyle drug".

Certain HRT types have been linked with an increased risk of breast cancer.

A recent study provoked widespread concern among women who take HRT to alleviate the symptoms of the menopause, such as loss of libido, fatigue and hot flushes.

Doctors are keen not to create a panic over HRT, which they say is safe, provided it is prescribed and monitored correctly.

However, the so-called "Million Women Study" has raised question marks over the safety of so-called "combined" HRT treatments, which contain the hormones oestrogen and progestogen.

Doubled risk

The massive study found that, over a ten year period, taking this combination doubled the risk of breast cancer.

Doctors are keen not to create a panic over HRT, which they say is safe, provided it is prescribed and monitored correctly.

However, the so-called "Million Women Study" has raised question marks over the safety of so-called "combined" HRT treatments, which contain the hormones oestrogen and progestogen.

Doubled risk

The massive study found that, over a ten year period, taking this combination doubled the risk of breast cancer.

The study found those taking oestrogen-only HRTs also had an slightly increased risk of breast cancer.

For every 1,000 women who use HRT for 10 years from the age of 50, there were an additional 19 cases of cancer in those using the combined oestrogen and progestogen version and an extra five in those using oestrogen-only HRT.

Approximately 1.5 million women in the UK currently take HRT.

However, all forms of HRT can help prevent osteoporosis, which can mean a much smaller chance of suffering a fractured hip later in life, which can be devastating to quality of life in the elderly.

Risks and benefits

Professor Purdie, who is head of the Royal College of Physicians of Edinburgh Consensus Committee on HRT, said: " While there are undoubtedly some risks associated with HRT, as with most medical treatments, there are many benefits associated with HRT and we have to be cautious in our interpretation of these studies before forming conclusions."

The government has already issued guidance to English doctors in the wake of the Million Women study .

It says that each decision to start HRT - or to continue using it - should be made with the potential benefits, and risks, to each individual patient in mind.

Treatment should be reappraised at least yearly, it says, and women who have concerns about HRT should make an appointment to discuss it with their GP rather than simply cease to take it altogether.

The Edinburgh consensus statement is expected to be similar to the English advice - stressing the benefits of HRT to most women, while advising women, particularly long-term users, to be aware of the likelihood of an increased risk of cancer.