Women turning to "untested" HRT alternatives

Health Sciences

University of Adelaide researchers have expressed concern over the number of women turning to alternative therapies for relief of menopausal symptoms.

Hormone replacement therapy (HRT) use is declining, but women still need relief from menopausal symptoms and are turning to 'alternative' hormone therapies, despite such therapies being unproven for safety and effectiveness.

That's the finding of a review carried out by Australian researchers - led by the University of Adelaide - using data from the South Australian Health Omnibus Survey (HOS).

The results were published last month in the international journal Climacteric.

The HOS is a regular survey of health-related issues in South Australia. The survey interviewed 953 women over the age of 40, which included 688 women over the age of 50. Women were asked about various health-related issues, including HRT use.
The main findings were:

• In 2004, 15.8% of women above the age of 50 were using HRT, a fall from 22% in the year 2000. In 2004, use of 'alternative hormonal therapies' was rare;
  
• In 2008, conventional HRT use over age 50 had dropped further to 11.8%, and the number of women taking alternative untested hormonal therapies had risen to 4.0%;
  
• Women wrongly identified alternative therapies such as 'bioidentical hormone therapies' as a safe hormonal alternative to conventional HRT.

Menopause specialists say the best and safest period to commence HRT is near the menopause. In 2008, 13.4% of women aged 50-59 years used HRT, compared with 7.7% in this age group who use unconventional, unregistered alternative hormones.

The lead researcher, Professor Alastair MacLennan, Head of Obstetrics & Gynaecology at the University of Adelaide, said he was concerned that women were turning to alternative therapies for relief of menopausal symptoms without knowing the facts.

"Alternative practitioners are capitalising on women's fears by promoting 'bioidentical' hormones, and herbal remedies," Professor MacLennan said.

"'Bioidentical' hormones are untested for long-term safety and efficacy and no herbal medicine has a greater effect than the normal placebo effect on menopausal symptoms.

"Most objective observers would agree that the risks of HRT were overstated following the early results of part of the US Women's Health Initiative study in 2002. HRT is still the best way to treat debilitating menopausal symptoms for the vast majority of women.

"These scares have led to HRT use dropping, but for many women, the need for help through the menopause has not gone away, and so women are turning to those selling unproven and possibly dangerous alternatives.

"It is important that women suffering from menopausal symptoms discuss evidence-based management with a qualified doctor before choosing treatment," he said.

The Chair of the International Menopause Society, Dr David Sturdee, said: "It's extremely important that women receive the correct treatment, rather than try something which may have no effect or may even be harmful. I'd urge women to contact their doctor before starting any treatment for menopause symptoms."

Story by David Ellis