HRT offers ‘huge benefits for women’ and should be the first line of treatment for menopausal symptoms, experts say

Hormone replacement therapy offers ‘huge benefits for women’ and should be the first line of treatment for menopausal symptoms, a health watchdog said today.

Bosses at the National Institute for Health and Care Excellence (Nice) say that ‘HRT is the preferred, recommended approach’ for relieving symptoms such as hot flushes, insomnia and low mood.

Taking the medication is unlikely to change life expectancy and should be offered to women after face-to-face discussions with their GP, Nice bosses say in guidance published today.

But in an apparent move away from draft guidelines published last year, it said cognitive behavioral therapy (CBT) should only be considered as an addition to HRT unless women are unable or unwilling to take the medication.

Last year’s draft guidelines said CBT could be used ‘alongside or as an alternative to’ HRT to help reduce symptoms of menopause. But this proposal was heavily criticized.

The change follows extensive consultation with healthcare providers, patients and research organizations, which the independent committee said was taken ‘very seriously’.

Hormone replacement therapy offers ‘huge benefits for women’ and should be the first line of treatment for menopausal symptoms, a health watchdog says today (file image)

Bosses at the National Institute for Health and Care Excellence (Nice) say HRT is the preferred, recommended approach to ease symptoms (file image)

In addition to the revised guidelines, the regulator has developed a ‘discussion tool’ for GPs and patients (stock photo)

Professor Jonathan Benger, chief medical officer and interim director of the Center for Guidelines in Nice, said: ‘HRT is our recommended first-line treatment for vasomotor symptoms (hot flashes and night sweats), and we recommend that this is offered to women. , provided it meets their needs, and after an informed discussion.

‘We have revised the guidelines to make it very clear that CBT is an adjunct, an additional therapy, and that it can help people manage symptoms… in addition to HRT, or some women may choose not to use HRT , or they may not be able to take HRT, and so CBT may be helpful at this point.

‘But we are very keen to emphasize that HRT is our recommended first-line treatment for vasomotor symptoms and for menopausal symptoms.’

In addition to the revised guideline, the regulator has developed a ‘discussion tool’ for general practitioners and patients.

This includes data on how HRT may slightly increase the risk of certain health problems, such as breast cancer and blood clots, while lowering the risk of osteoporosis. A review of the evidence found that there was no link with an increase in heart disease, stroke or dementia when HRT was started at the typical time of menopause, between 45 and 55 years.

Marie Anne Ledingham, Clinical Advisor at Nice, said: ‘While there are some increased risks associated with using HRT for menopausal symptoms, there are obviously a huge number of benefits for women.

‘The updated guidelines advise healthcare providers to tailor information about the benefits and risks of HRT for these individual symptoms based on the person’s age, their individual circumstances and any additional potential risk factors.’