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CHECK UP
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Thursday 15:00-15:30
Check Up is your chance to talk to doctors about the health issues that most concern you and your family. Each week Barbara Myers is joined by a medical expert to take your calls and emails on a particular topic and give you the most up to date advice. No appointment necessary.
Call 0870 010 0444
checkup@bbc.co.uk
LISTEN AGAINListen 30 min
Audio currently unavailable for 4 December
PRESENTER
BARBARA MYERS
Barbara Myers
PROGRAMME DETAILS
Thursday 4 December 2003
white pills

HRT

Women are being warned not to use hormone replacement therapy to prevent osteoporosis, or brittle bone disease. The advice - from the Medicines and Healthcare Products Regulatory Agency - follows a Europe-wide review of the balance of risks and benefits of long-term HRT use. In the last few months HRT has been blamed for 20,000 additional cases of breast cancer in the UK over the last ten years. Last year around two million British women – a third of all those between the ages of 50 and 64 – were taking one form or other of HRT but the adverse publicity has meant hundreds of thousands of women have since turned their backs on it.

HRT and the Heart
Ten years ago HRT was being promoted as a way of protecting against heart disease but recent studies show it increases the risk of heart attack – how could we have got it so wrong? And what is  the evidence behind the burgeoning alternative market - what are the natural alternatives to HRT, which ones work and are they any safer?

Menopause
Hormone replacement therapy involves replacing oestrogen – the female hormone produced by the ovaries. Natural levels of oestrogen fall dramatically when the ovaries cease functioning and periods stop (the menopause). The average age for the menopause in the UK is 51 although there can be considerable individual variation.

Why HRT is Prescribed
HRT is prescribed for two main reasons – to help women with the short-term symptoms of the menopause (such as hot flushes, night sweats, cystitis and vaginal dryness), and to help protect against osteoporosis (1 in 3 women over 50 develop excessive thinning of the bones and HRT slows the process).

Advice Against
The Medicines and Healthcare Products Regulatory Agency is now advising against HRT being used as the therapy of choice for preventing osteoporosis in women over the age of 50.

How HRT Works
There are numerous forms of HRT but the key ingredient is oestrogen . Women who still have their wombs (the majority) need to take another hormone – a progesterone-type compound – to protect the lining of the womb (prescribing oestrogen on its own in these women increases the risk of cancer of the uterus).

Studies
Two major studies, one involving a million women, have recently linked the use of all forms of HRT to an increased risk of breast cancer, stroke, heart attack and potentially life-threatening clots (deep vein thromboses).

New Advice
The new advice suggests that prescribers use the lowest effective dose for the shortest possible duration and that the treatment should be re-evaluated at least annually in light of new knowledge and any changes in the woman's risk factors.

For younger women who have a premature menopause, HRT may be used to treat their menopausal symptoms and to prevent osteoporosis, until they reach the age of 50, when treatment should be reviewed.

Contact the Programme
If you have a question, contact us by calling 0870 010 0400 from 1.30pm on the day of broadcast or emailing checkup@bbc.co.uk

Next week’s topic is: Hepatitis.
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