Are Doctors Overprescribing Hormone Replacement Therapy For Menopause?
In recent years, the debate around hormone replacement therapy (HRT) for menopause has gained significant attention. Once seen primarily as a relief for women dealing with symptoms of menopause now it is becoming a broader topic in healthcare, leading to questions from the medical community about whether it is being overprescribed. A key figure in this ongoing conversation is Dr. Louise Newson, a prominent menopause specialist in the United Kingdom, whose practice and advocacy for HRT recently became a subject of scrutiny.
Before looking at as being overprescribed, we need to know exactly what is HRT and what does it do. Hormone replacement therapy involves taking synthetic estrogen with or without synthetic progesterone to replace the hormones the body slows down producing during the peri and postmenopausal period. Many women have found HRT to be beneficial for alleviating the bothersome symptoms of hot flashes/night sweats, mood swings, vaginal dryness, brain fog, and osteoporosis.
However, HRT has not always been looked at in a positive light. There was some controversy from early studies done in the 2000s suggesting a possible link between HRT and an increased risk of breast cancer, heart disease, and strokes. More recent studies have debunked that link due to the cohort of women studied had pre-existing conditions and older than what was recommended to start HRT. The research has now indicated that the benefits of HRT may outweigh the risks for women, particularly those under the age of 60 and within 10 years of menopause onset
In the UK, prescriptions for HRT have dramatically increased over the last several years. The renewed interest in HRT is driven by evolving clinical guidelines, research, and greater public awareness about menopause. Advocates for HRT, such as Dr. Louise Newson, have played a significant role in increasing the visibility of menopause care. Dr. Newson specializes in menopause and founded the Newson Health Menopause & Wellbeing Center and has become a leading voice in advocating for better menopause care, including HRT. Recently, Dr. Newson has faced criticism, particularly regarding the safety of HRT use and whether her advocacy has led to overprescribing. This controversy has placed her under the spotlight, prompting a closer look at whether doctors are now overprescribing HRT based on a one-size-fits-all approach. Dr. Newson has consistently maintained that while HRT is not right for every woman, it should not be dismissed based on outdated studies or misconceptions.
At the annual meeting of the Menopause Society, which took place recently in Chicago, there was concern from many attendees about the increase in misinformation about the management of menopause and HRT. It was stated that not many women receive guidance regarding menopause and menopause symptoms and in the United States hormone therapy usage remains at an all-time low. While not all women will need HRT, they all should know it is available, what the current guidelines are, and what symptoms it could help with to make their own informed choices for their bodies.
Based on existing science and clinical evidence, The Menopause Society does not recommend estrogen-containing hormone therapy for primary prevention of cardiovascular disease or dementia, management of musculoskeletal conditions outside of osteoporosis risk reduction, prevention of aging, or management of other primarily age-related changes such as hair loss, skin changes, or weight gain.
For women to make informed choices about their bodies, they depend on their doctors to give them accurate information about HRT, including both the risks and benefits based on their overall health. This allows women to make decisions in partnership with their healthcare providers that best suit their individual needs and not a cookie-cutter quick fix. Women deserve personalized, evidence-based care that considers all options, including lifestyle changes, non-hormonal treatments, and, when appropriate, HRT.
