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NICE recommends HRT in first menopause guidance

11 November 2015

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The National Institute for Health and Care Excellence (NICE) has today released their first guidance on menopause, and has stated that health professionals can recommend HRT (hormone replacement therapy).

GPs should now offer women HRT for hot flushes and night sweats, and consider HRT to ease the low mood that can arise as a result of the menopause.

However, health professionals should of course discuss the risks and benefits of the therapy, and explain that oestrogen-only HRT has little or no increase in the incidence of breast cancer, while HRT with oestrogen and progestogen can be associated with an increase in the incidence of breast cancer, but any increased risk reduces after stopping HRT.

Dr Imogen Shaw, a GP with a special interest in gynaecology and a NICE guideline developer said: “For the last decade, some GPs have been worried about prescribing HRT, and women worried about taking it. I hope that this new NICE guideline will empower women to talk to their GP or practice nurse about menopause… For health professionals, the guideline should boost their confidence in prescribing HRT, having fully discussed the woman’s individual circumstances with her.” 

An estimated 1.5 million women – around 80% of those going through menopause – experience some symptoms, which typically continue for around four years after the last period, but can last for up to 12 years.

The guidance also says that women with cardiovascular risk factors should not automatically be excluded from taking HRT and to ensure that menopausal women and healthcare professionals involved in their care understand that HRT does not increase cardiovascular disease risk when started in women aged less than 60 years, and it does not affect the risk of dying from cardiovascular disease.

The average age for menopause in the UK is 51 but it can vary widely depending on lifestyle and ethnicity, and premature menopause affects 1 in 100 women under the age of 40.

See the full guidance here