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At last, a low-dose HRT pill 'without any side-effects'
Last updated at 00:52am on 07.07.07
Health fears: HRT use has dropped
Thousands of women having a hysterectomy can now take low-dose HRT to stop hot flushes and thinning bones without any fear of side-effects.
An oestrogen-only pill has been launched for women under 50 who face a premature menopause because of womb surgery.
The pill meets new guidelines to minimise the risk of side-effects caused by Hormone Replacement Therapy because it contains half the dose of oestrogen in standard drugs.
Specialists believe it could halt the decline in women turning their backs on HRT following controversial research which raised fears that the treatment can cause heart disease, blood clots and cancer.
It is estimated around one in five women in the UK undergo a hysterectomy before the age of 52, which can trigger an early menopause even if the ovaries are retained. The new low-dose pill Premarin contains 0.3mg of oestrogen, less than half the standard HRT preparation of 0.625mg. The hormone combats symptoms such as hot flushes and night sweats.
It also fights bone thinning which affects women after the menopause and can lead to osteoporosis and broken bones.
Dr John Stevenson, consultant metabolic physician at the Royal Brompton Hospital in London, and chairman of the charity Women Health Concern, said: "This is good news for hundreds of thousands of women who have had a hysterectomy because until now there has not been a choice of low-dose HRT."
He said it could also be taken by women using Mirena, a coil releasing hormones directly into the womb. "Women still get benefit from low-dose oestrogen which lessens the risk of side effects such as thrombosis, or blood clots, and breast tenderness. But the lower the dose the better", he added.
Dr Stevenson, who has carried out a review of the latest evidence into HRT safety with Professor Richard Farmer, emeritus professor of epidemiology at Surrey University, said it should reassure millions of women who have been unnecessarily deterred from taking HRT drugs.
The number of prescriptions has fallen by almost half in six years - down by almost 3million from the high of 6.3million in 2001 - with the number of users falling from 2million to just 1million.
Safety concerns rose in 2002 when the U.S. Women's Health Initiative study claimed patients using HRT were at higher risk of heart disease and strokes - contrary to previous research which suggested oestrogen could protect them from heart problems.
But earlier this year re-analysis of the data found the extra risks may apply only to patients in their 60s and 70s, who do not normally use HRT.
A report last year said an apparent rise in breast cancer among current users was not significant when the data was correctly analysed.
The research looked at both oestrogen-only HRT and combined HRT, which contains the hormone progestogen. This is used to protect women with a womb against a higher risk of cancer of the womb lining.
There is already a combined pill containing half-dose oestrogen and progestogen for women who have not had hysterectomies.
Professor Farmer said: "Based on the current evidence, we conclude that women starting on HRT below the age of 60 are not at increased risk of adverse events other than a slight increase in risk for blood clots amongst users of combined HRT.
"This risk could be decreased by the use of the new low-dose HRT preparations. For women aged below 60 there is a decreased total mortality and a decrease in fractures.
"HRT should be considered firstline therapy for relief of menopausal symptoms, and for prevention of osteoporosis in women of this age with increased risk for the disease.
"It is not possible to predict from current trials the effect of long-term HRT use in these women but it would certainly appear to be free from significant risk for at least seven years.
"The increase in coronary disease, osteoporosis and deaths resulting from the drop in use of HRT will only become apparent in future years."
Reader views (2)
As a clincal psycological therapist i am constantly coming across women who are dealing with surging anxiety and an inability to cope with life alongside usual symptoms of menopause due to surgical menopause. However GP's fail to perscribe a drug which could help and give back life to these women. Why? how can a women in her forties and sometimes thirties be expected to live and function without her vital hormones. No one seems to understand the devastating effect this is having on lives. We replace insulin and thyroid hormones however female hormones are not perscribed as a matter of course. In the meantime huge amounts of funds and time in mental health services are being used to help these patients deal with their depleted lives, this is not including those who suffer in silence.
- Concerned, Tyne and Wear
I would dearly like to read any reviews by women using the mirena coil and low dose oestrogen. I have tried 2 forms of HRT and have suffered too much bleeding. 2 years ago I had the mirena coil and I was comfortable with using the coil but it needed to be removed twice due to cervical biopsies. In 10 days I have chosen to have mirena coil and will be given a low eostrogen pill. I am a little nervous but assume , if I did not take any form of HRT, then my menopausal symtoms would be suitably unpleasant.
- Susan Cowe, England
