New Hormone Replacement Therapy guidelines supported
The Ministry of Health welcomes the new guidelines on combined hormone replacement therapy released today.
"Since the release of the Women's Health Initiative study in June 2002 that demonstrated that the risks of combined HRT
outweigh the benefits, practitioners have waited patiently while the Guidelines Group and the Medicines Adverse
Reactions Committee completed a review of the literature on the safety of HRT," said Medsafe senior advisor Dr Stewart
Jessamine.
" The advice issued today by these two committees give clear and unambiguous advice to practitioners that use of HRT
should be for a limited number of indications and in most women for a limited period of time."
The key messages from MARC support and extend the advice issued by the guidelines group to inform practitioners and
consumers that:
· Use of combined HRT should normally be used only where menopausal symptoms are disruptive to the quality of life of
the woman; · HRT should not be used for the primary or secondary prevention of coronary heart disease or stroke; · In
most circumstances, the risks of long term treatment outweigh the benefits; and combined HRT should not be used for
longer than 3-4 years; · Oestrogen-only HRT increases the risk of breast cancer and venous thromboembolism to a similar
extent as combined HRT; · All prospective and current users of HRT should be advised of the risks and benefits of
oestrogen and progestogens; · The need for continued treatment with HRT should be reviewed at the woman's next visit to
her General Practitioner and thereafter on a yearly basis.
"In light of this new advice the Ministry of Health is recommending that all women on HRT should be reviewed at the time
of their next prescription to determine the reasons why they are using HRT and to be advised of the risks and benefits
of continued therapy to allow them to make an informed choice." Dr Jessamine said.
The MARC and Guidelines Group advice will be distributed by Medsafe, to every prescriber and pharmacy in the country.
Messages will be sent out next week.
The Guidelines Group document and covering letter, and MARC advice is available on the Medsafe website: http://www.medsafe.govt.nz