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.
Source : British Medical Journal.