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The Pharmaceutical Journal
Vol 269 No 7207 p89
20 July 2002

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No immediate changes to HRT are necessary, says Health Department

Results of the Women's Health Initiative study reported last week (PJ, 13 July, p43) do not necessitate any immediate changes to the treatment of women receiving hormone replacement therapy (HRT), says the Department of Health.

In advice issued to health professionals following media coverage of the trial, Dr Pat Troop, deputy chief medical officer, said: "This information confirms what we already know about HRT. Women who feel they benefit from taking HRT do not need to stop taking it but should discuss their individual benefits and risks with their GP."

The message from the trial is that women should not use combined HRT purely for long-term prevention of heart disease, says Dr Troop.

The Department points out that the women treated in the American study were older than most women using HRT in the United Kingdom. In addition, the combination product used in the study (conjugated equine oestrogens 0.625mg and medroxy-progesterone acetate 2.5mg daily) was for continuous use whereas in the UK most products are for cyclical use.

The Committee on Safety of Medicines considered a pre-publication copy of the WHI study. Its conclusion is that the balance of risks and benefits of HRT for its licensed indications remains favourable.

Full details of the Department's advice are available from the Medicines Control Agency website (www.mca.gov.uk).

Risk of ovarian cancer with HRT Women who use oestrogen-only hormone replacement therapy, particularly for 10 years or more, are at increased risk of ovarian cancer, researchers report in JAMA (2002;288:334).

From a cohort of 44,241 postmenopausal women, they identified 329 who developed ovarian cancer during 20 years of follow-up and observed that ever use of oestrogen-only HRT was associated with increased risk of ovarian cancer (rate ratio 1.6, 95 per cent confidence interval 1.2–2.0). The researchers add that for each year of use there was a 7 per cent increase in rate ratio.