Menopause news

Langer Paper - RCOG/BMS Statement

14 March 2017

Heather Currie, Chair of the British Menopause Society (BMS), said:

“Professor Robert D Langer’s paper, The evidence base for HRT: what can we believe?, is an interesting and welcome review of the 2002 Women’s Health Initiative (WHI) clinical trial of hormone replacement therapy (HRT). The study and subsequent report, which emphasised the risks of HRT, caused worldwide concern which led many women to refuse treatment.

“This new paper highlights the serious errors that were made during the WHI study and publication of results including little involvement from key investigators and conclusions made that did not accurately reflect the scientific findings. Professor Langer also highlights that the study was designed to test the effects of HRT in older women, yet the conclusions applied the exaggerated risks to all women. Clinicians have been struggling for nearly 15 years to disprove some of the information in the report which was incorrectly deemed as factual. Since then, many women who needed HRT but avoided it, have suffered unnecessarily.

“Over recent years, reanalysis of the data and consideration of further research has led to a better understanding of the risks of HRT. Evidence shows that the risks are small and, for most women, are outweighed by the benefits if treatment is started before 60, or within 10 years of the menopause. Benefits include symptom control as well as improved urogenital, bone and cardiovascular health. This is reflected in Professor Langer’s paper which points out that the WHI study did not show any statistically significant increased risk of breast cancer or heart disease in women using HRT.

“Published online in Climacteric, Professor Langer’s important revelation puts to rest the incorrect perception of risks of HRT, and also calls into question the publication process.”

Edward Morris, Vice President for Clinical Quality for the Royal College of Obstetricians and Gynaecologists (RCOG), said:

“The RCOG and BMS have worked hard over recent years to provide women with the correct information about HRT to make a properly informed decision. In 2016, the BMS and Women’s Health Concern published updated recommendations on HRT in menopausal women, while last month the RCOG launched an information hub about menopause and women’s health later in life. NICE’s guideline on Menopause: diagnosis and management has also significantly helped both women and clinicians in understanding the evidence behind the advice we provide.”

“While not every woman requires HRT, all should have access to accurate information about the consequences of menopause and treatment options, and the reassurance that HRT remains a low risk and beneficial treatment for most women."

See the The Langer Paper here - The evidence base for HRT: what can we believe?

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