Don't panic, says HRT doctor

The doctor who sparked panic among millions of women who take hormone replacement therapy with research showing that it carries long-term health risks, today urged calm.

Jacques Rossouw carried out a study which showed that while many women take HRT to protect themselves from the risks of breast cancer, heart attacks and strokes, it can actually significantly increase the chance of developing these diseases.

The number of women in their fifties and sixties who take HRT rose from about five per cent 10 years ago to a current high of more than 30 per cent, after a series of studies in the late Nineties claimed that it could prevent cardiovascular disease and other illnesses.

More than two million women are taking some form of HRT at any one time in the UK, and the patches, pills and implants are now multi-million-pound profit-leaders for many pharmaceutical giants.

But that could all change as a result of Dr Rossouw's study, the Women's Health Initiative, which involved more than 16,000 women and was expected to last for eight years in order to examine the longterm effects of HRT.

The American study was abandoned yesterday, three years early, as the findings had already begun to show that the risks related to HRT significantly outweighed the benefits. Researchers found that HRT increased the risk of invasive breast cancer by 26 per cent, of heart attacks and other coronary events by 29 per cent and of strokes by 41 per cent. It also doubled the risk of blood clots.

An editorial in the respected Journal of the American Medical Association, which published the findings, recommended that women should not be prescribed the type of HRT involved in the study over a long period.

However, as medical experts warned that sales of HRT could plummet, Dr Rossouw seemed to back track. Speaking on Radio 4's Today programme, he said: "It's not an urgent alert situation, there's no emergency here."

But rather than reassure listeners that HRT was safe, Dr Rossouw added: "In the longer term, if you use it for several years, you are not likely to gain health - you are likely to lose health."

Professor Valerie Beral of Oxford University is behind a separate study into the long-term effects of HRT and links with breast cancer, heart disease and strokes, which is expected to be the most comprehensive conducted.

The "million women" study, started in 1997, is tracking one million British women on different types of HRT. She is expecting to publish her results in the next two years. Professor Beral, head of the Cancer Research UK Epidemiological Unit at Oxford, said: "I think this will lead to a major change in the way people look at and prescribe HRT and I suspect that the numbers of women who take it will drop. There has been a long history of HRT being hyped and people saying it is good for health and can prevent heart disease, and that led to the massive rise in people using it in the latter half of the nineties.

"A lot of women take HRT not because it gets rid of the symptoms of the menopause, but because they were told it had preventative effects."

Professor Beral praised Dr Rossouw's study, she said: "This study is very important and has been very well conducted. What it shows is that there isn't any protection against heart disease from taking HRT. We do not know what our study will show but the results from the American study are very interesting. This research makes it very hard to stand by any claims that HRT is good for long-term health."

The increased risks associated with HRT highlighted by the US research related to a specific type of drug called Prempro, in which the hormones oestrogen and progestin are combined. Prempro is not available in the UK, But a similar preparation-called Premique, made by the same company, Wyeth, is widely prescribed in this country and used by more than 300,000 women.

Doctors today, followed Dr Rossouw's lead and urged women not to panic or stop taking HRT as they braced themselves for a flood of calls from worried patients.

Professor David Purdie, one of Britain's leading experts on HRT, based at Hull University, said: "The absolute risk of these adverse events is extremely low and that is what women need to remember."