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The National Institute of Health and Care Excellence (NICE) has advised GPs to offer hormone replacement therapy (HRT) as the primary method of treatment for menopausal symptoms. In its latest guidelines, NICE has said that talking therapy may be used as an additional form of help in conjunction with HRT. Previous studies analysing the correlation between HRT and disorders like cancer, dementia, stroke, and heart disease demonstrate that HRT does not decrease life expectancy.
The guidelines also include a discussion aid aimed at helping GPs provide the most useful information available on HRT drugs’ effects. HRT replaces oestrogen and progestogen hormones after menstruation stops (usually between age 45 and 55). This treatment is usually given to women by creams, sprays, patches, pills, and Pessaries, and during perimenopause, it is occasionally administered; they start to vacillate but the menstruation doesn’t stops altogether.
During updated menopause guidelines, NICE says that healthcare professionals should consider an individual’s position and provide all the necessary information to make the best decision about treatment. According to NICE, HRT is the best course of treatment to alleviate hot flushes and night sweats caused by menopause. Talking therapy known as CBT (Cognitive Behavioural Therapy) should be provided to women over 40 in conjunction with HRT or, if needed, in place of HRT.
Despite the increased risks associated with taking HRT, the guidelines inform GPs that the treatment is unlikely to lengthen or shorten life expectancy. The guidance includes easy-to-read illustrations of the likelihood of developing certain illnesses, which can help GPs have informed discussions with patients. Dr Marie Anne Ledingham, consultant clinical adviser to NICE, said that the scientific evidence available was assessed by an independent panel to get the information. The risks of coronary heart disease, stroke, ovarian and endometrial cancer were not higher among women aged 45 and over taking combined HRT in comparison to their counterparts who have never tried it.
The risk of developing fractures related to osteoporosis, a bone condition, which is more likely to develop after menopause, has decreased significantly after taking HRT. However, the risk of breast cancer for women did increase, affecting 79 in every 1,000 taking combined HRT for five years from the age of 50 and 92 in every 1,000 taking combined HRT for ten years. The risk of women developing dementia was slightly higher if women began treatment after the age of 65. At the same time, no increased risk was identified in younger patients.
In recent years, the UK has seen a significant rise in HRT prescriptions. Professor Jonathan Benger, Chief Medical Officer at NICE, said the country’s awareness of the impact of menopausal symptoms on women has increased, and there is a need to improve treatment access for women from ethnic minority backgrounds and from poorer areas
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