Latest menopause study

Read the latest article from Dr Karen Morton following the recent Lancet publication on menopause

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As World Menopause Day approaches (Friday 18 October 2019) I am sure the surge of concern which followed Prof Valerie Beral’s publication in the Lancet on September 28 2019 will have faded from the press-generated hysteria into a proper perspective.

Everything we do in life is a balance of risk. When you get in the car you know you must drive carefully, but even with your seat-belt on and a clear head, accidents happen. You subconsciously decide that the small risk of an accident is worth the reason you started the engine and set off on your journey. Deciding to take hormone replacement therapy is not such a dissimilar decision. Women who think about health, and who come to menopause at around the average age and who have nothing much in the way of symptoms may decide to start HRT to prevent certain problems, or they may decide to concentrate on other ways of staying as healthy as they possibly can. Those women (about 1 in 4) whose lives are turned upside down due the severity of their symptoms should be given the most accurate information available and then be allowed to choose whether to take HRT. They should be given the best and the safest variety, bespoke to their circumstances and needs. So did the publication of the Lancet paper by the Oxford team change that in any way? I don't really think so. Its findings were largely in agreement with previous studies which are summarised in the 2015 NICE guidelines on management of the Menopause. There is a very small but statistically significant increase in the incidence of breast cancer in women on mainly combined HRT using synthetic progestogen. This effect is much more pronounced in women who are overweight.

The new finding was that this small increased risk continues above background levels for 10 years after stopping the HRT.

The study fails to report the known fact that women who develop breast cancer whilst taking HRT are much less likely to die from it that those who develop the disease when not taking HRT. The women who take HRT are also much less likely to die from a heart attack. It was reassuring to hear from celebrities like Liz Earle and Mariella Frostrup giving their personal perspective on the new data, reading that leading breast surgeon, Prof Kefah Mokbel clearly say that he would still prescribe HRT will have empowered many women to realise that the choice is theirs.

So women should not be frightened. They should get the very best advice they can and make their own choice. Dr Morton’s is here to help.