AUSTRALIAN doctors are being told to reconsider hormone replacement therapy for menopause after a major review found the controversial treatment was safe for most women in their 50s.
Over the past decade, hundreds of thousands of women have abandoned or avoided HRT to treat symptoms of menopause because a 2002 US study said it dramatically increased the risk of heart disease, strokes, breast cancer and blood clots.
Australia's leading experts on menopause said the study had scared a generation of Australian women off using HRT, exposing them to debilitating symptoms including hot flushes, insomnia, joint pain and fatigue.
Australasian Menopause Society president Dr Jane Elliott said the review would be used to educate doctors about the updated information on the benefits and risks for women. ''I hope GPs start feeling more comfortable prescribing this for healthy women at the time of menopause for symptoms,'' she said, adding that the treatment would not be for everyone, especially those at risk of particular illnesses.
The controversial Women's Health Initiative study made public in 2002 followed 16,608 women aged 50 to 79 for an average of five years. But a group of experts, including some who worked on the original study, said a comprehensive reappraisal published this week showed that most participants were over 60 and had experienced menopause at least 12 years earlier, making the results irrelevant for menopausal women in their 50s.
In a series of articles published in Climacteric - the journal of the International Menopause Society - the specialists said the latest research showed the benefits of HRT for healthy women in their 50s significantly outweighed the risks and, in some
cases, HRT offered significant protection against heart disease, osteoporosis and colorectal cancer.
In one of the articles, Professor Henry Burger, emeritus director at Melbourne's Prince Henry's Institute, said it could be argued that, since 2002, untreated symptomatic women had lost the best years of their lives. ''In particular, women who have had a premature or early menopause are the most disadvantaged if they have been dissuaded from taking HRT because of the media image of the WHI results.
They will be at increased risk of osteoporotic fractures, premature cardiovascular disease, premature dementia and a major decrease in sexuality and quality of life,'' he and his colleagues wrote.
Rod Baber, general secretary of the International Menopause Society and an associate professor of obstetrics and gynaecology at Sydney University, said the 2002 study resulted in a drop in HRT use among women over 50 from about 30 per cent in 2002 to about 15 per cent now.
He told The Age that, for healthy women in their 50s, combined HRT - oestrogen and progesterone - would not increase the risk of breast cancer if they took it for less than five years. Symptoms generally last two to five years. In women who took it for more than five years, it caused one extra case of breast cancer in every 1000 women each year and one extra stroke for every 1000 women each year.
If HRT was taken orally, he said, the risk of a blood clot increased somewhat, with one extra case of deep vein thrombosis in very 10,000 women. However, he said if women took oestrogen only, there was a long-term decreased risk of breast cancer, and combination HRT improved heart and bone health.
About 2 million Australian women are going through or approaching menopause, when menstruation ends and the body's production of the sex hormones oestrogen and progesterone drops off. About 80 per cent experience moderate or severe
To Read more click on the Rockpool book, by Barry Wren: Menopause: Change Choice and HRT
Julia Medew – 23 May, 2012