Overview

In the UK, the prescribing of hormone replacement therapy (HRT) to treat menopausal symptoms began gradually in the 1950s and reached a peak around 2002. HRT appeared to have an additional role in the prevention of chronic disease in older women. As a consequence, the indications for prescribing HRT increased to include prevention of cardiovascular disease, osteoporosis and Alzheimer's disease, as clinicians were keen to promote use for these apparent important benefits.However, the last 2 years have seen a steady decline in prescribing rates as a number of key publications have added greatly to our knowledge on the benefits and risks of HRT. The expected cardiovascular protection of HRT has not been demonstrated and one study has confirmed the increased risk of breast cancer associated with use of HRT. The 47th Study Group of the RCOG met to debate all these issues concerning the role of HRT in menopause management. Clinicians, epidemiologists and scientists scrutinised the data and, although consensus was not achieved in all areas, greater understanding and agreement did occur. Without doubt, HRT will continue to be prescribed for women with severe menopausal symptoms but some of the other indications will now be relegated to the archives of history. It has taken many decades to reach our current level of knowledge of HRT and the situation may still change. This Study Group leads the way for a greater understanding of the complex balance of risks and benefits of HRT for each menopausal woman considering such therapy.

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9781281894434

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