Researchers at Leicester University carried out a clinical decision analysis on the benefits and harms of HRT, based on the best currently available evidence. The study population was white women in the United Kingdom, aged 50, with or without menopausal symptoms, who had used combined HRT for five years.
In women free of menopausal symptoms, their analysis showed a net harm associated with HRT use, which increased with increasing risk of breast cancer. However, it showed HRT to be on average beneficial in women with menopausal symptoms, with benefit decreasing with increasing risk of breast cancer.
These results agree with the recommendations of the UK Medicines and Healthcare Products Regulatory Agency, say the authors. However, overall benefits depend highly on the severity of symptoms and the associated effect on quality of life.
As such, they suggest that a decision analysis tailored to an individual woman is more appropriate in clinical practice than a population based approach.