'HRT in lower dose relieves menopause distress'

The distressing symptoms of menopause can be successfully treated with a much lower dose of hormone replacement therapy (HRT) than previously used and osteoporosis prevented, a medical meeting in Dublin has heard.

Dr Nick Panay, consultant obstetrician and gynaecologist at Chelsea and Westminster Hospital, London, and director of West London Menopause Service, explained that using a lower dose of HRT resulted in fewer side effects such as breast tenderness, mood disturbances and lowered the risk for adverse events such as stroke.

"Preliminary results suggest there is also a lower risk of breast cancer, but that certainly requires confirmation," he said.

Dr Panay pointed out that new studies had found women who used ultra low doses of HRT had a significantly reduced incidence of bone fracture which was maintained after treatment was stopped, therefore HRT should be used as a first-line therapy in younger menopausal women to prevent fractures.

Speaking at the fourth annual symposium of the Irish Menopause Society in Dublin at the weekend, Dr Panay said HRT use had fallen by 50 per cent after the publication of the Million Women Study and the ensuing media hype and there had been a rise in the number of women turning to alternative therapies and unregulated products to treat the symptoms of menopause.

Considerable benefits of HRT that had not emerged in the original study had come out in subsequent reanalyses, he explained. The study had found there was no increased risk of cardiac heart disease in women aged 50-59 and in fact there was a 30 per cent reduction in mortality. There was an increase in deaths in the 70-79 age group who should never have been included in the study, Dr Panay said.

Dr John Stevenson, consultant physician at the National Heart and Lung Institute, Royal Brompton Hospital, London said: "I feel a lot of menopausal women have been left behind. The majority of women experience one or more severe symptoms of menopause yet only 22 per cent of women in the UK are taking HRT. I think a lot of women are suffering in silence."