The truth about HRT

Survey after survey has linked hormone replacement therapy to cancer, strokes, blood clots and heart disease. Why, then, are so many women so relaxed about using it? And why do some doctors insist that the dangers are exaggerated? Sarah Boseley investigates

It was the mid-60s and sex had emerged into the daylight. Young women had the pill and those who felt so inclined shortened their skirts and slept around. But why should they have all the fun? The hormone industry was about to deliver for their mothers, too - or perhaps one should say for their fathers.
In 1966, one of those epoch-changing books was launched on a generation of women around the age of 50. It told them that they did not have to lose out on the hormonal revolution. In fact, it implied it was their duty not to lose out. Forever Feminine, by Dr Robert Wilson, a gynaecologist in Manhattan, told them that the menopause was a disease that could be treated. They could stay well, beautiful and sexually active - they could, in fact, continue to please their husbands - if they took hormone therapy. They must simply replace the oestrogen their bodies had stopped producing.

It was the beginning of a myth that has resolutely refused to die - that HRT will undo the ageing process. Over most of the past four decades, women have been prescribed HRT for all sorts of reasons, not just to stop menopausal hot flushes and night sweats and strengthen their bones, but to improve their sex life, their hair, their skin and their morale. For a long time it was almost a case of, well, why not?
Wilson's book was funded by Wyeth, one of the biggest manufacturers of HRT. But that fact did not emerge until 2002, when his son admitted it to the New York Times just the day after a major trial - astonishingly, the first randomised controlled trial on the effect of HRT on women - was stopped three years early. The trial, known as the Women's Health Initiative (WHI), was set up after repeated calls from women's health activists to find out whether, as drug companies and doctors believed, HRT prevented heart disease. Shockingly, it found the opposite to be true. By far the most common form of treatment, which combines oestrogen and progestin, actually increases the risk of heart attacks, blood clots and strokes. The investigators pulled the plug when they found that women taking it also had a greater chance of invasive breast cancer. The WHI is one of the two biggest and most important studies ever carried out on the effects of HRT. The other is the Million Women Study in the UK, which has published a series of papers on breast cancer and other risks with HRT. The latest bad news from this hugely respectable study, published in the Lancet in April, is that HRT must have caused 1,000 deaths from ovarian cancer between 1991 and 2005.

Source - Guardian