I thought the article by Hickey et al. provided a comprehensive overview on the use of hormone replacement therapy in women with troublesome vasomotor symptoms.(1) I was surprised, however, that they failed to suggest low-dose oral progestogen as an alternative to HRT for menopausal symptoms. Medroxyprogesterone acetate (10mg) daily has been shown to be as effective as conjugated equine oestrogen (0.6mg) in controlling flushes and sweats
following surgical bilateral oopherectomy in premenopausal women.(2)

(1) Hickey M, Elliott J, Davison SL. Hormone replacement therapy. BMJ 2012;344:44-49
(2) Prior JC, Nielsen JD, Hitchcock CL, Williams LA, Vigna YM, Dean CB. Medroxyprogesterone and conjugated oestrogen are equivalent for hot flushes: a 1-year randomized double-blind trial following premenopausal ovariectomy.Clin Sci (Lond). 2007;112:517-25.

Competing interests: None declared