The big HRT rethink

Forget all you thought you knew about hormone replacement therapy. Views on their risks and benefits are changing

So what’s the latest thinking?

That, far from being a risk to women’s health, hormone replacement therapy (HRT) is not only the most effective way to deal with many menopause symptoms,it may improve health. Some experts say that oestrogen reduces the risk of heart disease (statistically a bigger threat to women’s health than breast cancer), dementia, osteoporosis and certain cancers – and that it actually increases your overall life expectancy.

What about the risk of getting breast cancer?

The risk was highlighted in a 2002 study by the Women’s Health Initiative (WHI), which linked HRT to an increased risk of breast cancer, stroke and heart attack. But critics point out that the study was flawed and inaccurate – the breast-cancer risk was, in fact, statistically insignificant (you have a higher risk of breast cancer if you’re overweight or you don’t exercise), and the HRT type studied was different from the HRT prescribed now.

What’s more, the average age of women used in that research was 63, when most would have started on HRT more than 10 years earlier, when menopause symptoms start and are usually most severe.

The group also had a higher-than-average collection of pre-existing health problems – half were ex- or current smokers, around 70% were overweight/obese, and over a third were being treated for high blood pressure. This would have raised their risk of many health conditions, including heart disease, stroke and certain cancers.

What symptoms can HRT help alleviate?