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GPs 'must warn' patients that HRT increases cancer risk, health chiefs say READ MORE: Only one in 5 women aware of hormone therapy cancer risks By Kate Pickles Health Editor For The Daily Mail and Eve Simmons Health Editor For Mailonline Published: 05:39 EST, 7 November 2024 | Updated: 05:50 EST, 7 November 2024 e-mail View comments Menopausal women must be warned that hormone replacement therapy (HRT) can increase their risk of breast, ovarian and womb cancers, new NHS guidance states. The drugs, which ease hot sweats and night sweats, offer 'enormous benefits', say health chiefs, but downsides must be outlined so patients can make an informed decision. The new guidance includes special recommendations for counselling women over 45, when health risks of the hormones are thought to increase further.
Overall, the guidance states HRT is 'the preferred, recommended approach' for treating some menopausal symptoms. However it is 'unlikely to change life expectancy' and 'personalised discussions' with a GP should inform whether or not a patient takes it. It comes after England's health watchdog, the Care Quality Commission (CQC), launched a probe into a celebrity-backed prviate menopause clinic over allegations it was prescribing patients very high doses of HRT.
More than a dozen patients from Newson Health — run by TV menopause guru Dr Louise Newson — told the BBC they'd suffered health problems due to the drugs. Some developed a thickening of their womb lining, a potential precursor to cancer . Hormone replacement therapy offers 'enormous benefits to women' and should be the first line of treatment for menopause symptoms, says a health watchdog today (file image) The British Menopause Society (BMS) removed Dr Newson from its register of menopause specialists last year as a result of the organisation's concern about her practices.
In a new statement, Dr Newson described the latest guidance update from the National Institute for Health and Care Excellence (NICE) as 'disappointing'. She added that 'the word risk is used three times as often as the word benefit'. Dr Newson said: 'The guidelines do not differentiate between older, synthetic HRT and the natural body-identical hormones now more commonly prescribed.
.. these newer forms offer more benefit than risks.
'The true risk comes in not taking HRT at all, with good quality evidence showing that low hormones increases the risk of heart disease, osteoporosis, type 2 diabetes and dementia.' In an apparent move away from draft guidelines published last year, NICE said cognitive behavioural therapy (CBT) should only be considered in addition to HRT, unless women are unable to, or do not want to take, the medication. The draft guidelines last year said CBT could be used 'alongside or as an alternative to' HRT to help reduce their menopause symptoms.
But this proposal was heavily criticised. The change follows extensive consultation with healthcare providers, patients and research organisations, which its independent committee said it had taken 'very seriously'. Dr Newson said: 'The guidelines do not differentiate between older, synthetic HRT and the natural body-identical hormones now more commonly prescribed.
.. these newer forms offer more benefit than risks' NICE boss Professor Jonathan Benger said: 'HRT is our recommended first-line treatment for vasomotor symptoms — hot flushes and night sweats.
'We recommend that [it] should be offered to women, providing that it meets their needs, and following an informed discussion. Alongside the revised guidelines, the regulator has developed a 'discussion aid' for GPs and patients. This includes data on how HRT can slightly increase the risk of some health conditions.
Read More Celebrity menopause doctor who campaigns with Davina McCall and Mariella Frostrup accused of putting women at risk of cancer by prescribing 'alarmingly high' doses of HRT A review of evidence found there were no links to increased heart disease, stroke or dementia when HRT was started at the typical time of menopause, between 45 and 55. The new NICE guidance also addressed the use of cognitive behavioral therapy, a type of psychotherapy, which has also been shows to help reduce some menopause symptoms. Prof Benger said: 'We have revised the guidelines to be really clear that CBT is an adjunct, it's an add-on therapy, and it can help people manage the symptoms.
.. in addition to HRT, or some women may choose not to take HRT, or they may not be able to take HRT, and therefore that's where CBT can be useful.
'But we are very keen to emphasise that HRT is our recommended first-line therapy for vasomotor symptoms and for symptoms of menopause.' Marie Anne Ledingham, consultant clinical adviser at NICE, said: 'While there are some increased risks associated with taking HRT for menopause symptoms, there are obviously an enormous number of benefits for women. 'The updated guidance advises healthcare practitioners to tailor information about the benefits and risks of HRT for these individual symptoms based upon the person's age, their individual circumstances and any additional potential risk factors.
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