WOMEN should not be put off using hormone replacement therapy (HRT) because of over-hyped fears about its health risks, a panel of international experts concluded yesterday.
The scientists said that for women aged 50-59 in the early years of the menopause, HRT was safe and effective.
The latest support for HRT comes after research linked its use to a greater risk of breast cancer and heart problems, which have led to
thousands of women abandoning the treatment.
The experts, including doctors and national organisations, said HRT alleviated menopausal symptoms, such as hot flushes, and maintained healthy bones without significant harmful effects.
Contrary to what many people had been led to believe, HRT did not raise the risk of heart disease for these women and its impact on breast cancer was "minimal", the experts said.
Although certain types of HRT containing combinations of oestrogen and progesterone could slightly increase the chances of developing breast cancer, their effect was dwarfed by other risk factors, according to the expert panel.
Dr David Sturdee, one of the report's authors, said doctors should be prescribing HRT more freely than they are. The current advice to health professionals is that HRT should be offered only to women with serious menopausal symptoms for the shortest time possible.
After five years doctors are not expected to continue prescribing the treatment without thoroughly discussing the potential risks with the patient.
However, Dr Sturdee said: "We feel women should have it for as long as they need it to maintain their quality of life."
Forty experts from around the world took part in a summit in Zurich to discuss the latest evidence on the health risks of HRT, with their findings presented at the World Congress on the Menopause in Madrid.
The scientists said the health hazards of HRT had been blown out of proportion largely because of misleading results from a major American investigation, the Women's Health Initiative.
After reviewing the evidence, the summit experts concluded that combination oestrogen and progesterone HRT did not raise the risk of heart disease in healthy women aged 50-59.
They said that oestrogen-only HRT, normally reserved for women who have had their wombs removed, actually decreased heart disease risk.
The report said oestrogen and progesterone HRT did slightly increase the risk of breast cancer for women in this group. However, the effect was minimal compared with other risk factors for the disease, such as obesity.
Dr Sturdee, a consultant obstetrician and gynaecologist at Solihull Hospital, said that at least one million women in the UK had stopped taking HRT because of unfounded health fears and had suffered as a result.
There were also reports of doctors imposing a blanket ban on HRT, even though this is at odds with guidelines. "Women's confidence has been shattered," said Dr Sturdee. "They are going to take a lot of convincing the initial reports weren't actually a reliable assessment of the data."
Ed Yong, of Cancer Research UK, said: "HRT is an effective way of relieving menopausal symptoms. Large studies have shown HRT can increase the risk of breast and womb cancers, but using it for a few years only has small effects and, after stopping, your risk returns to normal."
Professor Valerie Beral, Professor of Epidemiology at the University of Oxford, said the expert group was only quoting a small fraction of the evidence. "All the regulatory bodies advise that if women need to take HRT they should do so for as short a time as possible," she said.
BACKGROUNDCONCERNS about HRT have grown in recent years, after research suggested increased risks linked to the treatment.
In 2002, a Women's Health Initiative (WHI) study produced data that appeared to show women on HRT were at a heightened risk of breast cancer and heart disease.
This led to large numbers of women shunning HRT and convinced many doctors that the treatment was not safe.
In 2003, the UK's Million Women Study also highlighted a doubling of the breast-cancer risk among patients on HRT treatment for several years. But now experts meeting in Madrid have questioned some of the research, saying it presents an unbalanced view.
In particular, WHI researchers were accused of focusing on the wrong group. The average age of the study participants was 63, whereas most women start taking HRT a decade earlier.
In addition, 36 per cent had high blood pressure, 49 per cent were current or past smokers and 34 per cent were obese – all factors that could contribute to health problems.
The full article contains 765 words and appears in The Scotsman newspaper.
