HRT under tighter rein

By REBECCA WALSH health reporter

Hormone replacement therapy should be reviewed by doctors every six months, say new Health Ministry guidelines.

The guidelines, which were revised following numerous studies showing the risks of HRT outweigh the benefits for menopausal women, also say the medication should be taken at the lowest dose for the shortest possible time.

HRT has been shown to raise the risk of breast cancer, stroke, clots, heart disease and dementia.

The Medicines Adverse Reactions Committee, an independent expert advisory body, said yesterday that HRT remained appropriate only for women with moderate to severe menopausal symptoms such as hot flushes and sweats.

Doctors have hailed the advice as sensible.

Previous advice said HRT use should be reviewed at the time of a woman's next prescription. But women would often ask for a repeat prescription over the phone.

Dr Stewart Jessamine, principal adviser at Medsafe, the Government's medicines regulator, said two studies had prompted the stronger advice.

The Women's Health Initiative, an American study of 16,000 women, was abandoned midway through last year after finding, for example, that seven more women in every 10,000 taking combined HRT - a combination of oestrogen and progestogen - could be expected to have a heart attack and eight more a stroke than those on a placebo.

The medication had also been found to double the risk of dementia in women aged 65 and over.

A British study published in August showed women taking combined HRT were twice as likely to get breast cancer.

Dr Bev Lawton, director of the Wellington Menopause Clinic, who described the advice as sensible, said HRT was appropriate for some women and the pros and cons should be analysed for each person.

What to do if you take HRT

New Health Ministry advice says GPs should talk to women six-monthly to review their use of HRT.

It recommends that HRT be taken at the lowest dose for the shortest time and only to treat moderate to severe menopause symptoms.

Information on how to reduce HRT use can be found on the New Zealand Guidelines Group website: NZGG

For information on the advice and studies: Med Safe