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Don't browbeat HRT patients – let them decide for themselves

I wish to take issue with the self-congratulatory letter regarding HRT by Dr Helen Grant (February 26). The American figures have been strongly questioned by experts in this country being of the wrong drugs on the wrong patients.

Until recently HRT was the only prevention of osteoporosis and remains the treatment of choice in early menopausal women.

It is curious the death rate from cancer of the breast is lower in women on HRT than not on HRT, there is a better prognosis of breast cancer in women on HRT compared with those not on HRT, and significantly lower in bowel cancer for women on HRT.

The quality of life is hugely better in many women and many do not want to stop taking HRT. Perhaps women on HRT are better monitored and the reporting of breast cancer more accurate. I do not prescribe with a family history of breast cancer.

I have used HRT treatment for prevention of osteoporosis as per Professor Nordin's work for the past 30 years; I have prescribed a lot of HRT. Breast cancer has not been a dominant feature in my practice. No case has been related to HRT. I cannot remember the last time I certified a death from breast cancer.

I suspect Dr Grant may find a lot of women with a painful back from wedge fractures from the mid-50s and that her mortality and morbidity from fractured neck and femur will exceed mine, but she will be responsible for their suffering and mortality.

Like contraception and termination, a doctor should not impose their prejudice and views on patients. It is the patient's unbiased informed choice, not the doctor's.

Dr Graham Barrowcliffe

Sheffield

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