Women and health professionals should make the decision jointly and review it periodically

In the United Kingdom women at midlife are facing the decision whether to take hormone replacement therapy or not. The backdrop to this includes widespread discussion in the media of hormone replacement therapy, high levels of lay awareness, a medical profession that is mostly pro-hormone replacement therapy (although expressing some concern about long term side effects such as breast cancer), one of the highest rates of breast cancer in Europe,1 and a large but changing clinical evidence base.2 In some regions the decision to use hormone replacement therapy or not may be less prominent in society owing to a different backdrop, such as low levels of breast cancer or less awareness of hormone replacement therapy. Furthermore the experience of the menopause is closely linked with a woman's physical and social environment.3 4 Interaction between health professionals and women about hormone replacement therapy is one of the ways in which the role and status of hormone replacement therapy …