Hormone replacement therapy offers “huge benefits for women” and should be the first line of treatment for menopause symptoms, a health watchdog says today.
Bosses at the National Institute for Health and Care Excellence (Nice) say “HRT is the preferred and recommended approach” to relieve symptoms such as hot flashes, insomnia and low mood.
Taking the drug is unlikely to change life expectancy and should be offered to women after personalized conversations with their GP, Nice bosses say in guidelines published today. But in an apparent departure from draft guidelines published last year, it said cognitive behavioral therapy (CBT) should only be considered in addition to HRT, unless women are unable or unwilling to take the drug.
Last year’s draft guidelines said CBT could be used “in conjunction with or as an alternative to” HRT to help reduce menopausal symptoms. But this proposal was harshly criticized.
The change comes after extensive consultation with healthcare providers, patients and research organisations, which its independent committee said it had taken “very seriously”.
Hormone replacement therapy offers “huge benefits for women” and should be the first line of treatment for menopause symptoms, a health watchdog says today.
Heads of the National Institute for Health and Care Excellence (Nice) say “HRT is the preferred and recommended method” to relieve symptoms
Professor Jonathan Benger, medical director and acting director of the Nice guidelines centre, said: “HRT is our recommended first-line treatment for vasomotor symptoms (hot flashes and night sweats), and we recommend that it be offered to women.” , as long as it meets your needs and after informed discussion.
“We’ve revised the guidelines to make it really clear that CBT is an adjunct, a complementary therapy, and can help people manage symptoms… in addition to HRT, or some women may choose not to take HRT, or it’s They may not be able to take HRT and therefore that is where CBT can be helpful.
“But we want to emphasize that HRT is our recommended first-line therapy for vasomotor symptoms and menopausal symptoms.”
In addition to the revised guidelines, the regulator has developed a “discussion aid” for GPs and patients.
This includes data on how HRT may slightly increase the risk of some health conditions such as breast cancer and blood clots, while reducing the risk of osteoporosis. A review of the evidence found that there were no links with an increase in heart disease, stroke or dementia when HRT was started at the typical time of menopause, between ages 45 and 55.
Marie Anne Ledingham, clinical adviser at Nice, said: “Although there are some increased risks associated with hormone replacement therapy for menopausal symptoms, there are obviously a huge number of benefits for women.”
“The updated guidance advises healthcare professionals to tailor information on 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.”