Susan Davis writes in an Editorial about menopausal symptoms that several highly effective oestrogen and progestin treatments are no longer available as a result of commercial decisions and hormone therapy for menopausal women is now considered a taboo.1 That is a very misleading description of the dangers of hormone replacement therapy (HRT).

The long-lasting and unjustifiable promotion of HRT was indeed a very profitable commercial undertaking as hormones became commonly prescribed drugs in many countries. However, the main HRT trials were prematurely terminated because of rapid increases in cancers and vascular diseases. Women taking combined progestin and oestrogen HRT have no overall improvement in the quality of their lives and are twice as likely to die from breast or lung cancer and suicide.2-5

The advice to take the smallest dose of HRT for the shortest possible time is also unjustifiable. The risk of venous thrombosis is highest in current users and breast cancer incidences decrease rapidly when hormone use is stopped.

Surely doctors should be investigating why some women have severe menopausal symptoms or steroid hormone withdrawal symptoms. In my experience over the last 40 years, menopausal symptoms are usually due to essential nutrients deficiencies, many of which are caused by taking progestins and oestrogens as contraceptives in the first place. There is no “desirable” dose or duration of use.

1 Davis S. Can the severity of menopausal symptoms be predicted? BMJ2012;344:d7664

2 Chlebowski RT, Hendrix SL, Langer RD, et al. Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women. JAMA 2003;289:3243-53.

3 Chlebowski RT, Kuller LH, Prentice RL, et al. Breast cancer after use of estrogen plus progestin in postmenopausal women. JAMA 2010;304:1684-92

4 Chlebowski RT, Schwartz AG, Wakelee H, et al; Women's Health Initiative Investigators. Oestrogen plus progestin and lung cancer in postmenopausal women (Women's Health Initiative trial): a post-hoc analysis of a randomised controlled trial. Lancet 2009;374:1243-51.

5 Price E. Increased risk of mental illness in oral contraceptive and hormone replacement therapy studies. J Nutr Environ Med 1998;8:121-127.

Competing interests: None declared