New Hormone Replacement Therapy guidelines supported

The Ministry of Health welcomes the new guidelines on combined hormone replacement therapy released today.

"Since the release of the Women's Health Initiative study in June 2002 that demonstrated that the risks of combined HRT outweigh the benefits, practitioners have waited patiently while the Guidelines Group and the Medicines Adverse Reactions Committee completed a review of the literature on the safety of HRT," said Medsafe senior advisor Dr Stewart Jessamine.

" The advice issued today by these two committees give clear and unambiguous advice to practitioners that use of HRT should be for a limited number of indications and in most women for a limited period of time."

The key messages from MARC support and extend the advice issued by the guidelines group to inform practitioners and consumers that:

· Use of combined HRT should normally be used only where menopausal symptoms are disruptive to the quality of life of the woman; · HRT should not be used for the primary or secondary prevention of coronary heart disease or stroke; · In most circumstances, the risks of long term treatment outweigh the benefits; and combined HRT should not be used for longer than 3-4 years; · Oestrogen-only HRT increases the risk of breast cancer and venous thromboembolism to a similar extent as combined HRT; · All prospective and current users of HRT should be advised of the risks and benefits of oestrogen and progestogens; · The need for continued treatment with HRT should be reviewed at the woman's next visit to her General Practitioner and thereafter on a yearly basis.

"In light of this new advice the Ministry of Health is recommending that all women on HRT should be reviewed at the time of their next prescription to determine the reasons why they are using HRT and to be advised of the risks and benefits of continued therapy to allow them to make an informed choice." Dr Jessamine said.

The MARC and Guidelines Group advice will be distributed by Medsafe, to every prescriber and pharmacy in the country. Messages will be sent out next week.

The Guidelines Group document and covering letter, and MARC advice is available on the Medsafe website: http://www.medsafe.govt.nz

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