Is HRT always the way forward?

ClockIn the news this week is the epidemiological study conducted by the Collaborative Group on Hormonal Factors in Breast Cancer funded by Cancer Research UK and the Medical Research Council.  Published in the Lancet 29th August 2019. The study was conducted from 1992 to 2018 and involved looking at the incidence of breast cancer in women who were using Menopausal Hormonal Therapy (MHT) for five years. From the data obtained, risk factors were calculated as follows:

MHT Increased breast cancer incidence
Oestrogen + Daily Progestagen 1 in 50
Oestrogen + Intermittent Progestagen 1 in 70
Oestrogen only 1 in 200

 

The risk associated with MHT usage for ten years was calculated to be twice as great. 

There is no doubt that for many women the menopause is a very difficult time and for some the only way through is to use MHT for relief.  However, there are other avenues worthy of consideration.

I draw your attention to the work of C. Relton and E. Weatherley-Jones (2005).  The two researchers carried out an audit into the effectiveness of the Homeopathy Service in the Sheffield NHS community menopause clinic.  The clinic was established to help women with severe menopausal symptoms who were unable to take hormonal replacement therapy (HRT) either because they did not want to, or because the side effects were too debilitating, or because the HRT was ineffective. The audit ran from 2001 to 2003.  124 women were referred to the Homeopathic Service to receive six consultations with a Homeopath on a monthly basis who would prescribe individualised homeopathic treatments. The women were monitored using Measure Yourself Medical Outcome Profiles (MYMOP). This is a patient generated outcome questionnaire.  MYMOP data was obtained at the outset and then at the end of the process from 102 women.   83 of those women reported an improvement in their primary symptom. The average decrease in symptom score severity was a value of 2 (0.8 decrease on the MYMOP scale is deemed significant).  This is at the accepted confidence value of 95%.  These figures are, to say the least, promising and worthy of further investigation.

References:

Collaborative Group on Hormonal Factors in Breast Cancer. (2019). Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Available: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext. Last accessed 31st August 2019.

C. Paterson. (2002). Measure Yourself Medical Outcome Profile. Available: http://www.bris.ac.uk/primaryhealthcare/resources/mymop/general-information/. Last accessed 31st August 2019.

C. Relton and E. Weatherley-Jones. (2005). Homeopathy service in a National Health Service community menopause clinic: audit of clinical outcomes. Available: https://www.researchgate.net/profile/Clare_Relton/publication/7773451_Homeopathy_service_in_a_National_Health_Service_community_menopause_clinic_Audit_of_clinical_outcomes/links/53f1d80f0cf26b9b7dd103. Last accessed 31st August 2019.