BMJ  2008;336:1148 (24 May), doi:10.1136/bmj.39583.774769.3A

Letters

Premature menopause

Hormone replacement therapy is indeed indicated

The first 100% of the full text of this article appears below.

I strongly disagree with Lewars’s conclusion about the use of hormone replacement therapy (HRT) in women with a premature menopause.¹ He is quoting the Women’s Health Initiative, which was undertaken in women older than 50 and does not pertain to women in their 30s or even younger with early ovarian failure.

Women with untreated premature menopause are at increased risk of developing osteoporosis, cardiovascular disease, cognitive decline, dementia, and parkinsonism.^{2 3} Therefore, a need for oestrogen replacement exists until the average age of the natural menopause, which is about 52 in the United Kingdom. This does not increase the risk of breast cancer.⁴ The recommendation for HRT use by Jones et al is in accordance with national guidelines.⁵

¹ Women’s Centre, John Radcliffe Hospital, Oxford OX3 9DU

---

Competing interests: None declared.

1. Lewars MD. Article’s recommendation of HRT is highly questionable. BMJ 2008;336:1033-4. (10 May.) doi:10.1136/bmj.39563.620266.80[Free Full Text]
2. Rocca WA, Bower JH, Maraganore DM, et al. Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology 2007;69:1074-83.[Abstract/Free Full Text]
3. Rocca WA, Bower JH, Maraganore DM, et al. Increased risk of parkinsonism in women who underwent oophorectomy before menopause. Neurology 2008;70:200-9.[Abstract/Free Full Text]
4. Ewertz M, Mellemkjaer L, Poulsen AH, Friis S, Sorensen HT, Pedersen L, et al. Hormone use for menopausal symptoms and risk of breast cancer. A Danish cohort study. Br J Cancer 2005;92:1293-7.[CrossRef][ISI][Medline]
5. British Menopause Society Council Consensus Statement. Premature menopause. www.thebms.org.uk/statementcontent.php?id=3

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Article

Outcomes other than recurrence should be analysed

Martin Kurzer, Alan E Kark, and Tahir Hussain
BMJ 2008 336: 1033. [Extract] [Full Text] [PDF]