Ever since Hormone Replacement Therapy (HRT) — the treatment that promised prolonged femininity and a new lease of life for women going through the menopause — came to prominence in the 1960s, it has been blamed for causing a multitude of illnesses including breast, ovarian and other cancers, strokes, heart disease and blood clots.

Repeated health scares have caused the number of women in the UK taking HRT to halve, from two million to one million, in the past four years and many of the 300,000 women who enter the menopause each year now consider alternatives to the therapy that was once considered liberating.

Trials that have contributed to the downturn in the treatment’s popularity include the Women’s Health Initiative study (set up to find out if HRT prevented heart disease as many doctors thought, but abandoned in 2002 when initial results proved the opposite), and the Million Women Study (funded by Cancer Research UK, the NHS and the Medical Research Council, which linked HRT to various forms of cancers).

In the aftermath of the Women’s Health Initiative (WHI) health scare alone about 340,000 women are thought to have stopped taking HRT.

But for every woman who is deterred because of these purported risks, there are many who find its ability to alleviate the misery of the menopause — its hot flushes, night sweats, disturbed sleep patterns and depression — impossible to replace.

HRT works by replacing the hormones — oestrogen and progestogen — that women’s bodies stop producing during and after the menopause. Of the two types available, combination tablets (containing both hormones) are the most widely used as a once-a-day tablet, while oestrogen-only patches, pills and implants are prescribed less often, partly because they have been shown to raise the risk of uterine cancer (women who have undergone a hysterectomy can safely take them).

“What is often overlooked is the sheer debilitation the menopause can cause many women,” says Dr John Stevenson, an HRT specialist at the Royal Brompton Hospital in London and chairman of the charity Women’s Health Concern. “The scaremongering simply adds to their confusion about whether or not they should take HRT.”

More often than not, he says, the benefits of taking it outweigh the risks. But women need to be well-informed enough to make the choice. “It is worrying to think women are suffering unnecessarily,” says David Sturdee, consultant gynaecologist at Solihull Hospital in Birmingham and secretary of the International Menopause Society. “And it’s very cruel to put them off HRT when it could possibly help ease their suffering.” So should you take HRT?

All specialists agree that whether or not to take HRT should be a matter of personal choice. But based on the scientific findings and evidence available, what should yours be?

SHOULD YOU TAKE HRT?

Yes: If you are going through an early menopause or have had a hysterectomy

David Sturdee says that “it is particularly important for women who go through an early menopause to consider HRT”. He says that the cancer risks associated with continued use are “irrelevant to younger women whose ovary function has been halted or destroyed through illness” and that replacing oestrogen can be particularly helpful for this group.