National Institute for Health and Care Excellence (Nice) has recently updated its guidelines to highlight Hormone Replacement Therapy (HRT) as the primary treatment for menopausal symptoms in women. The focus has shifted towards offering HRT as the initial option for managing symptoms like hot flushes, insomnia, and low mood. This update comes after previous suggestions that Cognitive Behavioural Therapy (CBT) could be considered before HRT, caused controversy.
The revised guidelines emphasize that HRT should be the first-line treatment, with CBT being an additional option for women who cannot or choose not to take HRT. Prof Jonathan Benger from Nice clarified that HRT remains the recommended approach for vasomotor symptoms, reassuring that HRT does not impact life expectancy. He stressed the importance of recognising the real struggles women face with menopausal symptoms and highlighted the role of CBT in helping individuals manage these symptoms effectively.
Marie Anne Ledingham, a consultant clinical advisor at Nice, acknowledged the initial controversy surrounding CBT and stated that significant efforts were made to review the wording and placement of CBT within the guidelines. The updated guidance also includes a discussion aid for GPs and patients, providing information on the risks and benefits of HRT, such as a slight increase in certain health conditions like breast cancer and blood clots while reducing the risk of osteoporosis.
The discussion aid aims to assist clinicians in offering personalised advice to women considering HRT, ensuring that individuals feel supported in making informed choices about their healthcare. Ms Ledingham highlighted the importance of individualised menopause care and empowering women to make decisions about their treatment options. The updated guidelines offer new insights and evidence on HRT, providing a wider range of choices for managing menopausal symptoms.
Overall, the revised guidelines from Nice underscore the significance of prioritising HRT as the primary treatment for menopausal symptoms in women. By outlining the benefits and risks associated with HRT and CBT, the updated guidance aims to empower women to make informed decisions about their health and well-being during the menopausal transition.