Health rating agency NICE says hormone replacement therapy (HRT) does not shorten or extend life expectancy for those using it to relieve menopausal symptoms. updated guide.

The conclusion followed a detailed analysis of data on links between HRT and conditions such as heart disease, stroke, some cancers and dementia.

The guidance includes a new discussion aid to help GPs give patients the most useful information they can about medicines and what they do.

It is also stated that talk therapy may be offered alongside HRT to help women cope with symptoms.

HRT replaces the hormones estrogen or progestogen, or both, when women stop having menstrual periods (normally between the ages of 45 and 55).

It is applied using gels, creams, pessaries, tablets or sprays.

In its updated menopause guidelines, NICE (National Institute for Health and Care Excellence) says healthcare professionals should consider a woman’s personal situation and provide all the information needed to help her make the best choice about treatment.

The guidance emphasizes that although some of the risks associated with taking HRT are increased, it is unlikely to extend or shorten overall life expectancy.

Easy-to-read illustrations are included that show the likelihood of developing certain health conditions. These aim to help GPs have informed conversations with patients.

Dr Marie Anne Ledingham, NICE’s consultant clinical advisor, explained that an independent panel assessed the available scientific evidence to reach the information.

The risk of coronary heart disease, stroke, ovarian and endometrial cancer is no higher in women aged 45 and over who take combined HRT than in those who have never used it, he said.

And HRT actually reduced the risk of fractures due to osteoporosis, a bone condition that is more likely to develop after menopause.

But the risk of breast cancer in women is slightly increased, affecting:

• 59 in every 1000 women who have never taken HRT

• 79 in 1000 people take combined HRT for five years from the age of 50

• 92 in 1000 people take combined HRT for 10 years

The risk of dementia was also slightly higher if women started taking HRT after age 65. The risk of developing dementia was not high in young patients.

“The risks in the population are very low and HRT can provide huge benefits at a very difficult point in many women’s lives,” Dr Ledingham said.

The guidance is clear that HRT is the go-to treatment option for hot flashes and night sweats caused by menopause.

Talk therapy, known as CBT (cognitive behavioral therapy), will be offered to women over 40 alongside HRT or instead of it if the patient’s individual circumstances require it.

This is a change from draft guidelines published in late 2023. caused argument by suggesting that talk therapy could replace HRT as a treatment.

The level of feedback NICE has received at this point has led to a longer than usual delay in the publication of final guidance.

Prescriptions for HRT has grown quite a bit in England in recent years.

NICE’s chief medical officer, Professor Jonathan Benger, said awareness of the impact of menopausal symptoms on women had increased in recent years.

But he said more could be done to increase support for women from ethnic minority backgrounds and poor areas, who were “often unaware of or unable to access treatments that could help them”.

“Women need to be confident that they will be offered advice and options that meet their needs and will be supported to make the right choices for them,” Prof Benger said.