Hormone Replacement Therapy Risks Known, Acted On
10 July 2002
ACTION has already been taken in New Zealand to counter an increased risk of women suffering breast cancer or heart disease as a result of taking hormone replacement therapy, the Ministry of Health says.
Overnight news stories from Europe and the United States report the results of the Women's Health Initiative study which found older women without menopausal symptoms taking combined hormone replacement therapy (HRT) were at greater risk of breast cancer and cardiovascular disease.
The National Institute of Health in the United States announced that it would discontinue the study of combined oestrogen and progestogen because of the increased risk of invasive breast cancer in women taking part.
Ministry spokesman Dr Bob Boyd said any woman currently taking HRT who has concerns should continue taking the medication and discuss it with their health professional during their next scheduled visit. The risks and benefits will vary for each woman and should be weighed up on an individual basis.
Dr Boyd noted the study looked at a group of older women without menopausal symptoms taking HRT - not the group usually prescribed HRT in New Zealand.
"Guidelines for prescribing HRT, first written in 1993, were revised last year by the New Zealand Guidelines Group on the suggestion of women's health campaigner Sandra Coney and others. Copies of the updated guideline were sent to all prescribers in June and July 2001. They were also publicised in Medsafe's quarterly Prescriber Update.
"The revised guidelines made it clear that, contrary to some earlier claims, HRT did not have a role in the prevention of heart disease. They also reinforced the message that longer-term use might be associated with an increased risk of breast cancer diagnosis."
"The Medicines Adverse Reactions Committee also discussed the issue, and requested a letter go to HRT manufacturers asking them to amend any datasheets which claimed HRT could help prevent heart conditions. The Ministry also requested the datasheet warn against starting HRT in women with heart conditions. The letter was sent in the last quarter of 2001. "
Dr Boyd said HRT was not recommended for routine use, but was still the single most effective treatment for symptoms like hot flushes, in helping prevent bone loss and is very effective in treating established osteoporosis.
"We were expecting new research results at the time the guidelines were being updated, and anticipated these studies would reinforce the advice. In fact results have come through earlier than we anticipated. We will again be putting this issue on the MARC agenda for further discussion," Dr Boyd said.