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GP vigorously defends GMC against its critics

New prescribing data shows how patients and GPs have lost faith in HRT, but experts now say the hazards were exaggerated. Rob Finch reports

HRT prescribing has plummeted by 15 per cent in the last year after a series of landmark studies questioned its safety record, figures from the Prescription Pricing Authority reveal.

News of the prescribing drop came as the Government's drug safety watchdog toned down its advice on the therapy, stating that the risk associated with HRT was only slight in most women.

Meanwhile, a key member of the Committee on Safety of Medicines (CSM) HRT working party has admitted that its warning to GPs in December to prescribe the lowest dose for the shortest period possible was too strong.

GPs were also advised not to use HRT as a first line treatment for osteoporosis.

Prescriptions of all sex-hormone drugs ­ almost entirely HRT products ­ fell by 15 per cent to 6.2 million items in the year to June.

GPs said the fall was partly due to women deciding not to initiate therapy or to discontinue treatment in the light of conflicting data.

Dr Anthony Seeley, a GP in Bridgnorth, Shropshire, and council member of the British Menopause Society, attacked the 'unbalanced propaganda' that had deterred GPs and patients from using HRT.

He said women with new onset menopausal symptoms were being 'more stoical' and putting up with symptoms.

But he added: 'As the dust settles people are starting to realise that we have been misinformed ­ the propaganda was unbalanced.'

In the latest issue of Current Problems of Pharmacovigilance, published last week, the CSM advised GPs that 'for the majority of women with menopausal symptoms that affect their quality of life the risk is generally small and is outweighed by the benefits of short-term treatment'. Women on HRT should have their medication reviewed annually, the CSM said.

Dr David Sturdee, consultant obstetrician and gynaecologist at the Solihull Hospital, West Midlands, and a member of the CSM working party on HRT, said previous CSM advice had been too heavily weighted towards epidemiologists' opinions rather than clinicians'.

Risks of black cohosh remedy

The CSM warned last week of the risk of hepatotoxicity from the herbal medicine black cohosh ­ a common alternative to HRT.

There have been 10 reports of suspected adverse reactions with black cohosh, the committee warned, including GI irritation, headache, dizziness and vomiting.

GPs have been urged by the CSM to ask patients if they are taking herbal medications.

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