ANOTHER week, another set of confusing headlines about hormone replacement therapy. “GPs wrong about HRT” proclaimed an international group of menopause experts, who said that some health concerns about HRT were not justified. Barely had that headline appeared, than along came “Oral HRT doubles the risk of blood clots”, prompted by a study in this week's British Medical Journal.

Part of the problem with knowing what to think about HRT is that the information we get has been clouded by an undercurrent of feeling that hormone treatments - and the Pill is another example - are somehow subverting nature. When it first appeared in the 1960s, HRT was enthusiastically portrayed as a way to turn back time. It allowed women (and back then women's sex lives were considered to be over by 40) to continue to enjoy sex well beyond 50.

Similarly the Pill allowed women to have sex without getting pregnant, putting them in control of their lives. It's unnatural, muttered some.

The headlines about potential dangers of the Pill and HRT have always had a misogynistic whiff about them. You women wanted a good time, now you are going to pay for it with your health.

The difficulties of getting a clear story about HRT have been added to by the fact that studies on long-term side-effects such as increased risk of breast cancer take decades to come up with definitive answers.

Actually, HRT started as a treatment for hot flushes and menopausal symptoms. But it rapidly earned a reputation as a means to turn the clock back, and to prevent osteoporosis and cardiovascular disease. It became a modern cure-all. It's not, but it is good at what it was designed to do.

So how do you decide whether to take it or not? It's about balancing risk and benefit. The example of the Pill is again instructive: women who gave up the third generation Pill after scares about blood clots may have got pregnant as a result - instantly increasing their risk of blood clot from 25 per 100,000 to 60 per 100,000. They forgot the reason why they were taking the Pill in the first place. It's the same with HRT. You have to think about the problems you would have without it - and for many women, the symptoms of the menopause badly affect their quality of life.

If you have no or only mild menopausal symptoms, or are at low risk of osteoporosis, then the risks of HRT are likely to outweigh any benefits. But if menopause symptoms are making your life miserable, the benefits will outweigh the risks, if you take the lowest possible dose for the least time. It's about what's right for you. Concentrate on that and you can ignore the headlines.

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