HUNDREDS of thousands of women are needlessly abandoning hormone replacement therapy because they misunderstand the risks of the treatment.

One of the leading researchers behind a study that raised widespread fears over the links between HRT and cancer, said that the benefits for women suffering severe menopausal symptoms far outweighed the risks.

Susan Johnson’s comments were yesterday backed by other experts who said that up to one third of the 340,000 British women who abandoned HRT since the Women’s Health Initiative (WHI) trial was published in July 2002 had done so unnecessarily. The study found that HRT increased the risk of heart attacks, breast cancer and stroke but that the chances of contracting such diseases were tiny.

Dr Johnson, Professor of Obstetrics and Gynaecology at the University of Iowa and a WHI investigator, told the American Association for the Advancement of Science conference that the study had turned many women who would benefit against HRT.

She said that they had formed the mistaken opinion that HRT was risky and unsafe, and were reluctant to consider it in any circumstances. Confusion was also rife among doctors, some of whom were giving their patients misleading advice based on the WHI data.

She urged women who use HRT to treat the unpleasant side-effects of the menopause, such as hot flushes, fatigue and mood swings, to continue to take the drug because the benefits clearly outweighed the risks. Only those women without severe menopausal symptoms who took HRT to protect against osteoporosis should consider stopping.

The WHI investigation of 16,608 women aged between 50 and 79, who did not have any adverse symptoms of menopause, found that women taking the drugs had a 26 per cent increased risk of breast cancer, a 29 per cent higher risk of heart attack, a 41 per cent higher risk of stroke, and double the risk of blood clots, when compared to a control group taking a placebo.

Though the headline figures were alarming, the actual risk for individuals was very small. Only 2.5 per cent of the women in the study actually experienced a health problem from HRT, and death rates were similar for both the HRT and control groups.

An individual woman’s risk of breast cancer is just 0.1 per cent higher each year if she takes HRT. The figures mean that if 10,000 women were to take HRT there would be eight more cases of breast cancer, seven more heart attacks or coronary events, eight more strokes, and eight more blood clots affecting the lungs. HRT is believed to have been responsible for 20,000 extra cases of breast cancer in Britain, among tens of millions of women who have taken it.

The benefits of taking HRT were smaller than the risks, however: there was a 37 per cent reduction in the risk of colon cancer, or six fewer cases among 10,000 women, and a 33 per cent reduction in the risk of hip fracture, or five fewer cases. Dr Johnson said: “One of the groups that has abandoned it are the women who have hot flushes, for whom HRT is still a safe and effective therapy. A lot of these women have abandoned hormone treatment, I think prematurely. It is very difficult to talk a lot of these women into reconsidering hormone therapy. I spend a lot of my time doing it.

“There are many women for whom HRT continues to be an excellent choice for the treatment of menopause-related symptoms. In my clinical practice, I’m putting a lot of women back on HRT.”

The WHI study made front-page news around the world in July 2002, when its co-ordinating committee decided to abandon the trial, citing preliminary results that made it unethical to continue.

But the WHI study looked only at one form of HRT — a combined oestrogen and progestin therapy known as PREMPRO. Approximately 300,000 women in Britain were taking a similar type of HRT before the WHI results were published, though this figure is now thought to have dropped appreciably. There are no reliable figures for the numbers of women who have given up HRT since the WHI results, but a recent study from New Zealand, published in the British Medical Journal, found that 58 per cent of those taking it stopped in the wake of the findings, and only 18 per cent later restarted treatment.

Peter Selby, an endocrinologist at the Manchester Royal Infirmary, estimated that a third to a half of the 1.7 million women on HRT could come off it because of confusion over the risks. He welcomed yesterday’s admission by Dr Johnson and said he hoped that it would help to reassure patients of the many benefits of the treatment.

John Studd, consultant gynaecologist at Imperial College London, said that the WHI report had been “seriously flawed” and that the researchers had held a press conference a day before the report was made available to medical experts, thus “amplifying” the impact of the scare. “It’s probably the most expensive and ill-conceived study in the history of medicine,” he said.

He welcomed Dr Johnson’s statement but was angry that, in addition to the damage caused by scaring patients away from HRT, doctors became too nervous to prescribe it.

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