OK to rethink HRT? New NICE guidelines recommend HRT as effective treatment for menopause symptoms

NICE has today for the first time said that HRT is an effective treatment for several menopause symptoms, and has recommended that GPs offer it for hot flushes and night sweats.

It is estimated that 1.5 women have some form of symptoms (that’s 80 per cent of women at menopause), meaning this could lead to many thousands being prescribed it.

The health watchdog’s aim with the new guidelines is for healthcare professionals to make help and information more easily available. It says women with menopausal symptoms should be advised of potential symptoms and that a range of treatments, of which HRT is just one, should be discussed.

Studies more than a decade ago linked HRT to an increased risk of breast cancer and led to a big drop in its use. Since then many women have steered clear of taking it, and GPs from discussing or offering it.

Today NICE sought to put it back on the agenda, saying that oestrogen-only HRT has little or no increase in the risk of breast cancer, and that while HRT with oestrogen and progestogen can be associated with an increase in the risk, this reduces after stopping HRT.

Related: Christina: My GP called me crazy – but HRT made me feel normal again

Helping women make their own decision

NICE’s guideline committee wants women to have the choice of making up their own minds about whether the benefits of taking HRT to relieve symptoms outweighs any potential risks.

Its guidelines state that GPs should explain the stages of menopause and its common symptoms to women, as well as advising them on lifestyle changes that can help their general health and wellbeing, the benefits and risks of treatments, such as HRT, and the long-term health implications.

It wants healthcare professionals to use its new guidelines to reassure women that HRT does not increase cardiovascular disease when started in women under 60, does not affect the risk of dying from cardiovascular disease, and is not associated with an increased risk of developing type 2 diabetes.

Professor Mary Ann Lumsden BW 120
Prof. Lumsden

Professor Mary Ann Lumsden, a consultant gynaecologist and chair of the NICE guideline development group, said: “The guideline looks again at the place of HRT in treating menopausal women. It emphasises that, for most women, HRT is a very effective treatment for several menopausal symptoms, for example hot flushing, and reduces the risk of osteoporotic fracture.

“Every woman who is worried about the effects that menopause is having on her life must be given the chance to find if there’s an option that works for her.”

Christine Carson, programme director at the NICE Centre for Clinical Practice, said: “Women don’t always get the help they need from their GP, practice nurse or hospital specialist – this guideline recommends effective treatments which can help. The message is clear: talk about the menopause with your clinician if you need advice on your symptoms.”

Samia al Qadhi, chief executive at Breast Cancer Care, responded to NICE’s recommendations with: “This new guidance offers much-needed clarity on the often debated topic of hormone replacement therapy (HRT) and breast cancer risk.

“While taking HRT over 50 is associated with a small increased risk of developing breast cancer, the biggest risk factors remain out of our control – being female and getting older. It is essential women have clear information to help make an informed choice about taking HRT.

“The impact of early menopause caused by breast cancer treatment has often been ignored. But the gruelling symptoms, such as hot flushes and night sweats, can hit women extremely hard at an already challenging time.

“We welcome these guidelines. It is vital all women have access to specialist support, helping to improve quality of life when menopausal symptoms hit.”

The full NICE announcement includes comments from members of its expert committee.

Last year, Christina Robert shared with us the story of her bewildering symptoms, a search for help that took her across the Atlantic, and how HRT finally made her feel normal again. Read Christina’s story of menopause misdiagnosis and how HRT changed her life.

Jacqui Gibbons is the editor of High50’s health channel, edits beauty and lifestyle, and writes about health trends. Follow her on Twitter @jacqui_journo