HRT should be offered as first-line treatment for menopause, says Nice

Women with menopause symptoms should be offered hormone replacement therapy (HRT) as a first-line treatment, not therapy, according to the National Institute for Health and Care Excellence (Nice).

Its final menopause guidelines for medics in England and Wales, published on Thursday, state that HRT is the preferred treatment for managing symptoms such as hot flushes, night sweats, depression and sleep problems, in what is seen as a climbdown from previous wording.

Controversial draft guidance published last November said women experiencing these menopausal symptoms could be offered cognitive behavioural therapy (CBT) “alongside or as an alternative to” HRT.

The draft guidance provoked widespread criticism that it put CBT on a par with HRT, thereby belittling symptoms and harming women’s health.

Nice said it has responded to the feedback and rewritten the guidelines, which now say CBT should only be considered for patients on HRT who still have symptoms, or those who are unable or do not wish to take HRT.

Prof Jonathan Benger, chief medical officer and interim director of the centre for guidelines at Nice, said: “We are not suggesting that CBT is an alternative to HRT. It’s not an either/or, and we have worked through the guidelines extensively to really clarify this point.

“We are very keen to emphasise that HRT is our recommended first-line therapy for vasomotor symptoms [night sweats and hot flushes] and for [other] symptoms of menopause.”

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Source: The Guardian, 7 November 2024