Taking up the slack from HRT

More than half the women participating in a trial in New Zealand stopped taking HRT after last year's Women's Health study, report researchers this week. Are natural supplements filling the gap?

More than half the women participating in a trial in New Zealand stopped taking HRT after a study last year linked the treatment to significant side effects, report researchers this week.

The study did not reveal if the women had found alternative treatments for menopause symptoms but the results suggest that large numbers of women could be seeking new options to help symptoms. The natural products industry has seen strong growth in soy isoflavones and other natural treatments in recent months, with Dutch firm Acatris reporting recently that its clients had more than tripled sales since last year.

The study began six months after the Women's Health Initiative results were published, surveying 776 women who were taking HRT.

Of 734 respondents, 423 (58 per cent) had stopped taking HRT when the results were published, 132 (18 per cent) had restarted at the time of the survey, and 291 (40 per cent) had not, write researchers in today's issue of the British Medical Journal.

Of the 132 women who restarted, 100 did so because of the return of symptoms, 16 because they 'felt better' on HRT, and 15 for other reasons.

Most respondents (83 per cent) reported that they had discussed HRT with a health professional. The authors also found that older age, use of combined HRT, and longer duration of HRT were associated with stopping HRT.

The researchers from the Wellington School of Medicine and Health Sciences said the data suggest that stopping HRT was consistent with updated international guidelines.

The 2002 Women's Health Initiative report showed that combined oestrogen plus progestogen increased rates of breast cancer, coronary heart disease, stroke, and venous thromboembolism in healthy postmenopausal women. They found decreased rates of hip fracture and colorectal disease but no 'global' benefit and concluded that combined oestrogen and progestogen was not suitable for the prevention of chronic diseases (JAMA 2002;288: 321-33).