Health evaluation body NICE says hormone replacement therapy (HRT) does not shorten or lengthen the life expectancy of those who take it to ease menopause symptoms. Updated guidance.

Its findings come after a detailed analysis of data on the relationship between HRT and conditions such as heart disease, stroke, some cancers and dementia.

The guidance includes a new discussion aid to help GPs give patients the most useful information about medicines and what they do.

And it says talking therapy can be offered to women with HRT to help them cope with symptoms.

When women stop menstruating – usually between the ages of 45 and 55, HRT replaces the hormones estrogen or progestogen or both.

It is administered using gels, creams, pessaries, tablets or sprays.

In updated menopause guidelines, NICE (National Institute of Health and Care Excellence) says that healthcare professionals should take into account a woman’s individual situation, and provide her with all the information needed to help her make the best choice on treatment. Should do.

The guidance highlights that although there are some increased risks from taking HRT, it is not likely to lengthen or shorten overall life expectancy.

Easy-to-read illustrations of the likelihood of developing certain health conditions are presented. These aim to help GPs have informed conversations with patients.

Dr Mary Anne Ledingham, NICE’s consultant clinical adviser, said an independent panel assessed the available scientific evidence to inform the report.

They said the risk of coronary heart disease, stroke and ovarian and endometrial cancer was no higher in women aged 45 and over who took combined HRT compared with those who had never taken it.

And HRT actually reduced the risk of fractures associated with the bone condition osteoporosis, which is more likely to develop after menopause.

But the risk of breast cancer increased slightly in women affected by:

• 59 out of every 1,000 women never take HRT
• 79 in every 1,000 people have been taking combined HRT for five years by the age of 50
• 92 out of every 1,000 people taking combined HRT for 10 years

The risk of dementia is also slightly higher if women start taking HRT after age 65. There was no increased risk of developing dementia in younger patients.

“The risks in the population are very low, and HRT may provide enormous benefits at a very difficult time in the lives of many women,” Dr. Ledingham said.

The guidance is clear that HRT is a treatment option for hot flushes and night sweats caused by menopause.

Talking therapy, known as CBT (cognitive behavioral therapy), is to be given to women over 40 along with HRT or, if necessary for the patient’s individual circumstances, in place of it.

This is a change from draft guidelines published in late 2023, which Reason Controversy suggesting that talking therapy could replace HRT as a treatment.

There was a longer than usual delay in issuing final guidance due to the level of feedback received by NICE at that point.

There are prescriptions for HRT increased significantly in Britain in recent years.

Professor Jonathan Benger, chief medical officer of NICE, said awareness of the impact of menopause symptoms on women has increased in recent years.

But she said more could be done to improve support for women from ethnic minority backgrounds and poor areas “who are often unaware of or unable to access treatments that can help them”.

“Women need to feel confident that they will be given advice and options that meet their needs, and that they will be supported in making the choices that are right for them,” Professor Benger said.