HRT safest with short-term unopposed oestrogens

Most women for whom hormone replacement therapy (HRT) is indicated can safely be prescribed short-term unopposed oestrogens, according to the latest review of HRT.

Published in Cancer Forum, the review recommends the use of unopposed oestrogens is preferable to other forms of HRT and is a “highly desirable” population health goal for the vast majority of women where HRT is indicated.

Author Professor Ian Olver, of the Department of Medicine at the University of Sydney1, said he reached the conclusion after analysing a wide range of studies, including the Million Women Study and Women’s Health Initiative.

“There are many conflicting studies and views among health professionals about the safety profile of HRT,” Professor Olver said. “But a broad assessment of population studies suggests unopposed oestrogens have a better risk profile than oestrogen-progestogen combinations.

“There are no data, for example, which would preclude prescribing short-term unopposed oestrogen HRT for a woman with severe symptoms of menopause, considering the low risk of adverse effects such as breast cancer balanced against a great improvement in quality of life.

“Even in women who have not had a hysterectomy and are at risk of endometrial cancer, their overall cancer risk has been shown as lower with unopposed oestrogens.”

(Source: Cancer Council Australia: Cancer Forum)