Good tidings for women on HRT

For many women struggling to deal with the symptoms of the menopause, the latest research on hormone replacement therapy (HRT) bears good tidings.

In what is one of the longest and largest trials involving HRT, scientists say the therapy offers many menopausal women a significant improvement in the quality of their life.

The major international study funded by British, Australian and New Zealand government research bodies, has added significance because it is free of any pharmaceutical influence.

The study, the "Women's International Study of long Duration Oestrogen after Menopause" (WISDOM), looked at the health-related quality of life in 5692 healthy women aged 50-69 living in Britain, Australia and New Zealand and assessed the impact of combined oestrogen and progestogen hormone therapy.

The study found that 3 out of 4 women, who complained of night sweats and hot flushes, found that these symptoms had vanished after a year of HRT use and even in women who were well past menopause and did not suffer hot flushes, there was a noted improvement in sleep, sexuality and joint pain as a result of HRT use.

Professor Alastair MacLennan, leader of the Australian arm of WISDOM and head of Obstetrics & Gynaecology at the University of Adelaide, Australia, says overall, quality of life improved, even when women did not have hot flushes and were well past menopause.

Professor MacLennan says there was a small but measurable improvement in quality of life and a noted improvement in sleep, sexuality and joint pains, but HRT users had more breast tenderness and discharge compared to those on a placebo.

Dr. Beverley Lawton, Head of WISDOM New Zealand, says the quality of life benefits of HRT may be greater in women with more severe symptoms near menopause and the new research suggests that HRT taken from near menopause avoids the cardiovascular risks seen when HRT is initiated many years after menopause.

The researchers say the risks of HRT can be reduced and its benefits maximized when the treatment is individualized to each woman and early start-up side effects can usually be alleviated by adjusting the treatment.

They say for most women with significant menopause symptoms, the benefits of HRT outweigh the risks.

They also add that latest analyses of the main long-term randomized control trial of HRT (The Women's Health Initiative) show that breast cancer is not increased by oestrogen-only HRT and is only increased in women using combined oestrogen and progestogen HRT after seven years of use.

They say if a woman feels that HRT is needed to ensure quality of life, then a safe regimen can be found to suit her.

Experts say the WISDOM study is reassuring and shows that there are real benefits for some women who elect to use HRT and that even older women may benefit from the therapy.

The International Menopause Society (IMS) says that HRT use can benefit women experiencing symptoms associated with the menopause, such as hot flushes, night sweats, aching joints and muscles, insomnia, and vaginal dryness and is generally safe for healthy women going through the menopause.

The IMS says Health risks with HRT use rise slightly after the age of around 59 and each woman needs to discuss her own medical circumstances with her doctor before deciding on HRT use.

The research is published the current issue of the British Medical Journal.