I've been reading all the posts here and as a newbie wanted to add a few comments.
I think it's pointless making comparisons between HRT research and negligence by pharma companies generally. HRT has been around since the 1940s. That's getting on for 80 years. We are learning all the time about the risks and benefits, especially as HRT becomes more individualised, which I understand is the way that certain consultants already work and hope to see all women treated like this in the future. By that I mean lower than standard doses, long cycle, use of bio identical hormones, Mirena as part of it, and so on - anything rather than just handing over a prescription for bog standard HRT pills. It is likely that risks and benefits will change as HRT becomes more tailored to each woman's needs and medical / genetic history - as is the future for cancer drugs too.
It's unlikely I believe that we will see massive trials in the immediate future simply on the basis of funding. The NHS and the MRC do not have funds for this kind of research when there are so many other 'more important' research areas like cancer and gene therapy (stem cells etc.)
That leaves it to the pharma companies to invest, but I think it's unlikely they will do a huge lot more. HRT is very cheap compared to lots of drugs- the wholesale price is actually less than a prescription fee. Even if all menopausal women used HRT it would be a drop in the ocean profit-wise for pharma companies who are focusing on treatment for heart disease, cancer, diabetes, obesity and so on.
I think one factor that has been overlooked in the debate here so far is that of consultants. They are the experts who chair the British Menopause Society and the IMS and they feed their expertise down to GPs. They are able to look at the research and interpret it to give advice to patients. Some have a genuine and active interest in menopause and carry out their own research.
HRT has risks and benefits- like any drug. No drug is risk free- not even aspirin.
The short term symptoms of the menopause don't kill. But long term deprivation of oestrogen especially for younger women, does. There are more women who die from the complications of broken hips- 14000 a year compared to 11000 deaths from breast cancer. The lifetime risk of a hip fracture is 1:6, breast cancer 1:9. These are serious issues and for many women using HRT for an early menopause or throughout their 60s when risks equal benefits, can be a life saver.
At the end of the day, you make a choice. You accept that there is probably a small risk for some women with HRT but it's not clear exactly how much. It may be 1 more case of breast cancer per 1000 women, it may be fewer. It may depend on the type of progesterone used, it may not. This is currently unknown though being researched and discussed amongst consultants in the UK.
As other posters have said, there are far greater risk which we take on a daily basis. It's dangerous to drive a car, or drink more than 1 unit of alcohol a day. 60% of women are overweight and inactive, which are bigger risk factors for breast and uterine cancers, but most women choose to ignore this as it requires willpower and effort to change.
There is no doubt at all though that oestrogen stops bone density falling and builds it up; the evidence for this is clear and no one contests that. It's also clear from much research so far that HRT started early in menopause can reduce heart disease.
http://www.bmj.com/content/345/bmj.e6409Menopause is natural, sure. But so is heart disease and cancer - they are called DIS-eases. Meaning our body is out of synch and something's gone wrong. As others have pointed out, in the past until around 1900, life expectancy for women was around 46. Many women would still be producing children up to when they died (perhaps in childbirth) so the menopause was not an issue. Women didn't work once they had children (not in professional roles as they were banned once they married) so life was very different. It's important to be kind to each other when talking about HRT because I suspect no woman uses it until she feels she HAS to in order to cope with work, family, and life in general. The last thing we need is other women beating us over the head saying we ought not to use it as it's some kind of vanity drug!
lecture over! Sorry to go on.
