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EDITORIALS: Helen Roberts Hormone replacement therapy comes full circle BMJ 2007; 335: 219-220 [Full text]

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Chucking out the proverbial baby with the bath water?

Peter H Sonksen   (9 August 2007)

Neuromuscular syndrome to consider in Hormone Replacement Therapy

Elias Ragi, None (single author)   (10 August 2007)

Chucking out the proverbial baby with the bath water? 9 August 2007
Peter H Sonksen, Emeritus Professor of Endocrinology St Thomas' Hospital & King's College, London SE1 7EH Send response to journal: Re: Chucking out the proverbial baby with the bath water?	The original use of HRT was to mitigate the effects of the menopause on osteoporosis and subsequently, after this was established there began a search for a 'panacea for life' that led to too high expectations concerning possible cardiovascular benefits. Now it's been shown that these don't exist let's not give up on HRT as it works (viz Table: Hip fracture 0.66 (0.45 to 0.98) Total fracture 0.76 (0.69 to 0.85)) and it doesn't kill you (viz Table: Total mortality 0.98 (0.82 to 1.18)). One of the major problems with 'journalism' (medical and lay) is that there is a constant search for drama and often this may hide the truth! Competing interests: None declared
Neuromuscular syndrome to consider in Hormone Replacement Therapy 10 August 2007
Elias Ragi, Consultant Clinical Neurophysiologist Royal Devon and Exeter Hospital, EX2 5DE, None (single author) Send response to journal: Re: Neuromuscular syndrome to consider in Hormone Replacement Therapy	Editor, BMJ In the BMJ of 4 August 2007, I read with interest “Hormone replacement therapy comes full circle”. Dr Helen Roberts elegantly weighs up the utility of hormone replacement therapy (HRT) on a balance between the expected - though uncertain - benefits of reducing cardiovascular, colorectal and bone disease, against the risks of breast cancer, stroke and deep vein thrombosis, concluding HRT is best reserved for treating menopausal symptoms. Towards the same, it would be important to consider the neuromuscular syndrome caused by abnormalities in reproductive hormones, especially HRT. This syndrome is common – when recognized. I described it on studying 170 patients over five years and I continue to see about two a week. The syndrome often outweighs any amelioration of menopausal symptoms by HRT. The letter in which I described the syndrome was published (in the Journal of Family Planning and Reproductive Healthcare 2007:33(2); 135) only in April and readers of Dr Roberts's article may still not be aware of it, hence this response. Dr Elias Ragi MBChB FRCP DPhil(Oxon) Consultant Clinical Neurophysiologist Royal Devon and Exeter Hospital Exeter EX2 5DW Copyright: I grant an exclusive licence on a worldwide basis to the BMJ Publishing Group Ltd to permit this article (if accepted) to be published in BMJ editions and any other BMJPGL products and exploit all subsidiary rights, as set out in your licence at bmj.com/advice/copyright.shtml. Conflict of Interest Notification: I have no competing, including financial, interests. Competing interests: None declared