Education And Debate

Controversies in Management: Hormone replacement therapy for all? Universal prescription is desirable

BMJ 1996; 313 doi: (Published 10 August 1996) Cite this as: BMJ 1996;313:350
  1. Philip Toozs-Hobson, wellbeing research fellowa,
  2. Linda Cardozo, professor and unit directora
  1. a Urogynaecology Unit, Department of Obstetrics and Gynaecology, King's College School of Medicine and Dentistry, London SE5 8RX
  1. Correspondence to: Professor L Cardozo, Department of Obstetrics and Gynaecology, 9th floor, Ruskin Wing, King's College Hospital, London SE5 9RS.

    At a recent European consensus development conference on the menopause (Montreux, Switzerland, September 1995) it was concluded that hormone replacement therapy improves the quality of life, increases collagen, reduces urinary symptoms, and improves cognitive function. Although hormone replacement therapy has become an everyday part of the lives of millions of women, there are three main reasons why many who would benefit do not take oestrogen supplementation.

    Why some women reject therapy MISCONCEPTION ABOUT THE MENOPAUSE

    Some women believe that the menopause is a natural event and that taking medication (hormones) should be avoided. These women are wrong: oestrogen deficiency is the unnatural state. In developed countries the menopause occurs at around 51 years of age, although in women who have had a hysterectomy it may occur slightly earlier. During this century life expectancy has increased from 62 to 80 years.1 Thus women now live more than one third of their lives after the menopause. …

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