First treatment for menopause should be HRT - watchdog

Women with menopause symptoms should be offered hormone replacement therapy (HRT) as a first-line treatment, according to the National Institute for Health and Care Excellence (Nice).

- Anna Bawden

Its final menopause guidelines for GPs, published today, state that HRT is the preferred treatment for managing symptoms such as hot flushes, night sweats, depression and sleep problems, in what is seen as a climbdown from previous wording.

Controversial draft guidance published last November said that women experiencing these symptoms could be offered cognitive behavioural therapy (CBT) "alongside or as an alternative to" HRT.

The draft guidance provoked widespread criticism that it put CBT on a par with HRT, thereby belittling symptoms and harming women's health. Nice said that it had responded to the feedback and had rewritten the guidelines, which now say that CBT should only be considered for patients on HRT who still have symptoms, or those who are unable or do not wish to take HRT.