Published: November 2002

Hormone Replacement Therapy - Rapid Review

Information on this subject has been updated. Read the most recent information.

Prescriber Update 23(3): 30-34
November 2002

In September 2002, Medsafe sent a letter about the safety of HRT to all doctors and pharmacies. It was accompanied by updated key messages on HRT prescribing from the New Zealand Guidelines Groups (copies of both documents are available on the Medsafe web site at The article below provides background information about the advice provided in the Medsafe letter.

At its meeting of 11 September 2002, the Medicines Adverse Reactions Committee (MARC) reviewed studies examining the safety of hormone replacement therapy (HRT). On completion of its review, the MARC concluded that HRT provides a number of benefits with respect to control of symptoms associated with oestrogen deficiency, such as flushing and night sweats, and in preventing loss of bone density. However, for most women the risks associated with long-term use of HRT outweigh the benefits.

These risks include:

In the opinion of the MARC, the increased risk of breast cancer and stroke means that the benefit:risk ratio for combined HRT products becomes unacceptable for most women after about 3 to 4 years duration of use.

To improve the safe use of HRT, the MARC recommends that:

Further information on the risks and benefits of HRT is described in the following article recently published in The Lancet, reprinted below with permission from Elsevier Science (The Lancet 2002;360:942-944). The MARC reviewed an advance copy of this paper and concluded that it provides a balanced and reliable overview of the available data on the risks and benefits of HRT.