The truth about HRT

Eileen Durward
Ask Eileen

16 November 2015

What's the latest?

The National Institute for Health and Care Excellence (NICE – the body that gives guidelines for treatments/drugs to doctors based on research evidence, which most doctors will then follow) are now saying that it is ok for doctors to give more women the chance to take HRT for menopausal symptoms such as flushes, sweats and low mood, despite all the evidence about cancer. Over the last few years there have been several studies revealing that there is a potential risk of breast cancer associated with taking HRT, and the end effect is that women have now lost confidence in HRT – not surprisingly!

What NICE are saying

So, NICE is now saying that HRT is still fine to take, as the risks are relatively small – 22 women in 1000 would get breast cancer over 7 years, but if they all took HRT there would be five extra cases. They are encouraging women who are suffering from hot flushes and sweats to go and see their doctor, and they are advising doctors to discuss the possible side effects of HRT with menopausal patients but to point out that the risk is worth taking if it eases menopausal symptoms.

HRT is absolutely necessary in some instances, such as after a total hysterectomy or if a woman’s symptoms are so severe that they are affecting her welfare. Most women don’t fall into these categories, and thankfully there is a wide range of natural remedies that can be helpful and also save them the worry of possible HRT side effects.

As the majority of doctors have no training in these remedies (although increasing numbers are informing themselves about the natural options), they only have antidepressants to fall back on if HRT is not wanted. I can see, therefore, that there’s a strong incentive to make it more widely accepted again despite the health concerns that remain. (And remember that NICE aren’t saying that all the problems have been solved, just that if you haven’t got cancer by the time you come off HRT then you’ll probably be fine.)

What's not being said

The one thing no one is saying, however, is that HRT does not get you through the menopause. When you come off it, the sudden fall in hormone levels will, very often, trigger menopause symptoms – often worse that the original ones. I know because every week I hear from women with this problem. Also, once hormone levels are no longer artificially raised by HRT, benefits to bone health (one reason that many women take HRT) are swiftly lost and bones return to pre-HRT density.

So please don’t think that anything has changed except NICE’s advice. Women deserve to know the whole truth, not just the bit that makes their doctor’s life temporarily easier.

Are you worried about taking or coming off HRT?

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