I am now 62 years of age and have been taking HRT in some form or other for the past twentytwo years. When I tried to stop taking it I went through the same loss of sleep, hot sweats, irritability, loss of memory, weight gain and terrible tiredness as before. My periods stopped at 36 years and the four years after that were miserable. I have just been to a different doctor to the usual one for a repeat prescription and been faced with hostility. He asked why I was still on HRT. I was told it was only intended for women who were working and after work ceased, so should the HRT. I am still working, feel well and happy, have regular checkups and intend to stay on HRT - the benefits outweigh the risks. There must be others like me around.

Jane Faiers, Worcester, England

About 6 years after my Hysterectomy for cancer , I was offered HRT which I duly took for a number of years and had only slight side affectes such as tender breasts but nothing more. After discussing with my Docter we reduced the dosage over a longer period than proscribed and I have had no effects since. But the most important point that he always made to me was to have the follow up Pap smear and the Breast screening once every three years . Every time I visit which is usually once a year I am asked ... are you doing the regular breast examination and have you had your test.
For me the regular monitoring of my body plus the healthy life style ( when I can ) makes me feel mor confidant about using the HRT. As a member of the million women survey I am pleased that they are alerting people to be more aware of the risks but it is up to each women to make an Informed decision and then get on with life!!

Morgan, Monrovia, Liberia

Now a retired GP I spent over 30 years listening to the suffering of my menopausal women patients. It seems clear that some women have virtually no symptoms, others suffer terribly for many years. Unfortunately the non-sufferers have limited sympathy for the sufferers. If you listen you come to appreciate how bad it can be, how variable are the results of treatment, both with HRT and alternative medicines, how ALL treatments have side effects, and how those with a financial interest seem to be more vocal about their products or exaggerate the side effects of the 'opposition'. Even doing nothing involves assessing the risks to that patient's life. The patient must choose after a balanced discussion, preferably taking away written information to consider at leisure. The media must stop using percentage increases to frighten patients just to sell more papers!

J.D.Simpson, Nottingham, UK

Further to the above comment, I have long suspected the Pill to be responsible for many cases of breast cancer, particularly amongst pre-menopausal women. I was once prescribed it for PMT for which I was desperate for a cure, but having read the enclosed leaflet, I did not take any. I felt I would rather be miserable than diseased. Being miserable led me to experiment with supplements and I found a combination of magnesium and starflower oil a great help. Women meddle with their hormones at their own risk, and I believe, stupidly. I would not dream of taking HRT whatever I feel like with the menopause. Too many women today exist on appalling diets and then wonder why they do not feel well. Drugs are not the answer. Doctors should also realise this. Menopause is a natural process, not a disease, yet the drugs given for it can cause disease. What madness is this?

jean, romney marsh, kent

I have been on HRT for 9 nine years (I'm 57). I felt very, very ill everytime I tried to stop. I could not get up from bed, let alone walk or do anything. Accordingly, I don't care anymore. I'm a very busy woman, I have many interests in life and lots of things to do. As Elizabeth says, all those diseases come inevitably with age. Better to live less than to feel like dying everyday. About black cohosh, I did try it but no avail. I just didn't work for me.

Julia, Lisbon, Portugal

The Million Women Survey uses a biassed sample. Worse, it is biassed with particular respect to the subject being studied, & so overestimates the effects. Large surveys have smaller statistical sampling errors but do not remove or reduce the bias effect.

The Million Women Survey studies women who have received & accepted an invitation to the national breast screening program. It therefore excludes precisely those who, like me, consider that their relative risk of breast cancer is low & is outweighed by the risk of a false positive result from screening.

Our numbers do not have to be large to cast doubts on these ovarian cancer claims

T Scott, London,

A different anecdote. Nearly every woman my wife and I know who have developed breast or ovarian cancer were pre-menapausal and therefore had not used HRT. That is the point of studies like this. Anecdotal evidence can be biased to support the point being made. Fortunately the increased incidence is relatively small, not much benefit though if it is you. One issue of concern however is that that HRT is prescribed to counter the effects of an enforced sudden menapause brought on by a hysterectomy performed as part of the treatment for ovarian cancer. It has to be questioned as to whether or not this is still a sensible treatment. When my wife was offered HRT as part of her treatment for ovarain cancer she felt it was a really daft idea.

Graeme, Taunton, UK

I can't be bothered to go and look up the details, but here in the US there was a massive drop in breast cancer diagnoses last year which coincided with a massive drop in HRT use following a scare (details of which also escape me but I think it was heart attacks). Funny that this wasn't referred to in this article.
Never been convinced about the so-called benefits of HRT - my mother went on and off it and frankly seemed to have more problems on than off. The hippies here swear by natural progesterone creams and phytoestrogens like flax oil for dealing with perimenopausal discomfort. And exercise. Harder to overdose, but sadly unpatentable and therefore unlikely to be marketed as madly as the rather suspect synthetic hormones. (Ever wondered why the doctor calls your pill progestogen rather than the hormone progesterone? Because it isn't - you can't get a patent on something that exists in nature).

Delilah, Maryland, USA

My mother was on HRT for fifteen years, as in the above post, when she tried to come off the symptoms would return, she was diagnosed with ovarian cancer almost two years ago, unfortunately very advanced, she is still under going treatment now. I myself am in the menopause, I wont be taking HRT. I have heard great things about black cohosh too!

Eve, Surrey,

I am 66-8/12 years. I was prescribed HRT at age 38. I will never stop thanking my G.P. for prescribing HRT even if I were to develop cancer and die from it. When I experienced the menopause at age 38 my quality of life deteriorated to misery. Loss of energy, loss of libido, hot flushes, night sweats, irritability and weight gain. Every couple of years I wean myself from HRT, only to be subsumed by fierce hot flushes, night sweats, panic attacks and palpitations. I did a gradual weaning again two months ago and still at 66 yrs plus - I was once again assaulted by these symptoms. Complete loss of any Joi de Vivre. So this week I'm back on HRT again and expect the symptoms to disappear.
I tried Black Cohosh and other alternative therapies Black Cohosh brought me out in severe itching on my upper arms and a rash that is just now disappearing - five years later.
I have had wonderful quality of life these past 20 years and I would never regret it. I always knew the risk of cancer.

Fran Salmani, London, U.K.

I have taken HRT, Trisequens for 15 years. There was an enforced break (against my wishes) for approx 6 months about 3 yrs ago. I have never felt so ill in my life during this time and as in the meantime certain voices were then coming out against the Million Women Study and the verdict, I was "allowed" to recommence HRT and within a few days I begain to feel more like my old self and in 2 wks was once more feeling like a normal person. The nurse who had insisted I cease the preparation made the comment "You dont need hormones at your age"! I was then about 57 and what does one deduce from that???? I find it hard to believe that anything which makes me feel, overall, so well, alive and vibrant can be doing me harm. I was determined that having ceased the treatment I would be "fair" in my approach - but I noticed I was mentally confused, felt angry, unreasonable, thought "old" and, honestly, I began to SMELL old, plus aching limbs, sweats, flushes, headaches etc. To each her own.

Bridget Harbottle, Virginia Water, Surrey

But many women would inevitably show up with these diseases in combination with HRT as both disease and HRT are (predominantly) experiences of the woman over 50.

You could say that having grandchildren or grey hair frequently occurs in women taking HRT-they do, but not as an effect but as a parallell devlopment in the lives of older middle-aged women.

Which is not to decry the new and important findings or to dismiss concerns over long-term hormone use, but to indicate how important it is to be careful with the evidence.

Elizabeth Speller, Gloucester, UK

It's interesting to note that there have been no comments from women taking HRT so far. I have never used it, but a number of my friends have. One suffered terribly during menopause (with amongst other things, diminished eyesight) and has carried on taking it in post menopause on a very light dosage as when she stops completely all the symptoms of hot flushes and sweats start again, with disturbed sleep patterns etc. I am interested to hear any opinions on black cahosh, which was recommended to me recently during a health screening by the resident doctor. Any feedback on this would be good.

Christine Plant, St Albans, UK

Why the extreme hostility to HRT? The increased RISK of breast cancer was 38% but this study was heavily criticised and the authors admitted that it had been "misinterpreted". The increase in RISK of ovaran cancer is 20% but it is statistical nonsense to add these percentages and say the increased risk of cancer is 60%! Is it the journalists or the doctors who exaggerate for effect? Women should be encourgaed to balance the increased risk of cancer, which is very small in absolute terms (8 in 10000 for breast cancer and 4 in 10000 for ovarian cancer) against the improved quality of life that HRT gives them.

Steve, Odessa, Ukraine

My wife has taken, first 'the pill' then HRT in a very small dose of oestrogen. During this time it has seemed that there have been alternating conflicting recommendations. Would the latest have anything to do with saving the NHS with some expence?

Alan Sparke, St Rémy sur Lidoire, France

It has been stated that HRT causes cancer in menapausal women but what about the contraceptive pills that the millions of women are using, that are made from synthetic hormones. How about them? Are they doing good or bad? Or is it too costly for NHS to admit that they are also a big menace for our health!!!!

Guldal, Manchester,

I agree with James. Here in Spain very few women have HRT, or even know about it and both me (British, 59) and my sister in law (Spanish,73) have not suffered flushes or hot night sweats. From my women friends in England I have only had negative feedback about it ( some drastic) so I also agree with Arthur it´s to do with what you eat. My british counterparts did not believe me when I said I had never had hot flushes.

Angela, Madrid, Spain

Why the extreme hostility to HRT? The increased RISK of breast cancer was 38% but this study was heavily criticised and the authors admitted that it had been "misinterpreted". The increase in RISK of ovaran cancer is 20% but it is statistical nonsense to add these percentages and say the increased risk of cancer is 60%! Is it the journalists or the doctors who exaggerate for effect? Women should be encourgaed to balance the increased risk of cancer, which is very small in absolute terms (8 in 10000 for breast cancer and 4 in 10000 for ovarian cancer) against the improved quality of life that HRT gives them.

Steve, Odessa, Ukraine

John Toy, and this newspaper, seem to be unable to understand risk.

"To put the findings in perspective, they mean that over a period of five years there is likely to be one extra case of ovarian cancer among every 2,500 women receiving HRT, and one additional death for every 3,300 women on the therapy".

This is a very small increase in risk, and may well be statistically insignificant.

There have been other health scares about HRT which have turned out to be bogus.

This and other newpapers greatly increase the ill effects of this kind of thing by making it headline news.

James, London,

My mother lived a very healthy lifestyle until she had a hysterectomy and then was persuaded to have hrt implants - soon afterwards she developed breast cancer at age 53. My aunt also took HRT and developed cancer of the womb. Both underwent surgery and survived - but both feel that the HRT was responsible.

Ingrid Brigstock, Rayleigh, Essex, England

At a recent Angie Best (former wife of George Best) health talk I learnt the Premarin was used as HRT. Premarin comes from a forced pregnant horse. I have to agree with Angie that there are natural alternatives, like Novogen red clover and a different lifestyle can help the menopause if one is able to place health at the top of priorities.
This begins with a re-education of nutrition, live food not dead food that has been processed or cooked and the enzymes destroyed. No dairy, alcohol, sugar and salt. A back to basics what Mother Nature intended. With a little effort one can grow wheatgrass and juice this wonderful gift from nature. It is said that there are more nutrients in a thimble full of juice than what you can get out of 10 pounds vegetables.
The benefits are you have control of the growing rather than relying on the supermarkets that freeze and spray their vegetable to prolong their life span.
There is no quick fix for good health or no magic pill.

ARTHUR BROCKLEBANK, Liverpool, England

The million women study is enormous and represents the sort of post-marketing surveilance that no other drug can match. Certainly it is a lot more poweful than an uncontrolled opinion about Mr Bartunek's friends and customers. Basically it is reassuring but there are some causes for caution. The benefits are ignored.

There is a danger that other products may be promoted as being safer on the grounds that no one has looked so carefully for evidence and so they are assumed to be safe. One such product is phyto-oestrogens that are promoted as "natural", effective and safe. Why plant oestrogens should be more "natural" for women than mammal oestrogens is a mystery when women are mammals not plants. There is no evidence that they do the job that is wanted and simply to assume safety in the absence of evidence is most unwise. We know about problems with HRT becase they have been examined. Promoting something that has not been tested and hoping for safety and efficacy is not wise.

paulhewish, hopton, norfolk

Premarin HRT is from a pregnant horse.This cannot be natural for a human to take. My sister has taken Novegen red clover , a plant extract

ARTHUR BROCKLEBANK, Liverpool, England

Nearly every woman my wife and I know that has developed breast, cervical or ovarian cancer had used HRT. The number of friends and customers (we own a health supplement company) in this category is too great to be a statistical accident. From our experience, I do not think that the studies that have recently come out "overestimates the breast cancer risk" at all. HRT was an easy answer to a problem that over 60% of western women experience. It's time to take another look at cultures where menopause symptoms are mild to none, and do the real work of finding answers for women who need real answers.

Arthur W Bartunek, new york, USA / NY