Undeclared conflict?

The columnist and childcare expert hasn’t a bad word to say about post-menopausal hormone therapy (HT), which she calls hormone “replacement” therapy (HRT).

On her website (click here), advising about menopause management: “The single most effective tool available is HRT. […] [It] is more than 90 percent effective. If you feel your doctor isn’t being very helpful or sympathetic, or won’t let you try hormone replacement therapy, seek an opinion from another doctor.”

Referring to osteoporosis she writes: “Consider HRT once you are menopausal. Taking oestrogen in combination with progestogen for 10-13 days a month seems to optimise bone health and prevent fractures”. She fails to mention any risks, or that HT is only recommended for osteoporosis prevention in women at high risk who cannot tolerate alternatives.

In 2012 in an article entitled “Why HRT is safe to combat menopause despite past scare stories” she linked the increased risk of cardiovascular disease identified in the WHI trials with the MMR/autism scare, and claimed without reference: “it’s been shown that HRT cuts the risk of heart disease in younger women”. (Click here).

In 2011 (click here) in response to a question from a patient whose GP was reluctant to prescribe HT because of a strong family history of breast cancer (grandmother, aunt and cousin), she wrote: “HRT is better than ­any other menopausal remedy by a long stretch”, suggested getting a second opinion, and ended: “I’m hopeful your gynaecologist will find ­a way to give you HRT”.

This is biased advice.  Since the Women’s Health Initiative trials confirmed that HRT increases the risk of breast cancer, heart disease and strokes, all governments have advised that it should limited to treating symptoms only, and used in the lowest dose, for the shortest time possible, and never for health promotion. The idea that it might reduce heart disease when started soon after the menopause is not born out by independent analysis of all the trial evidence, e.g. the latest Cochrane review here. It remains a fringe obsession of a few “experts” with ties to the HT industry. Dr Stoppard is entitled to her views but she also has a conflict of interest.

According to Debrett’s People of Today (click here) she worked for Syntex Pharmaceuticals Ltd between 1968 and 1981. She was associate medical director 1968-71, deputy medical director 1971-74 & 76 , and medical director 1974-76, & 1977-81. In 1991 she became a director of the Syntex Corporation and remains so to this day. Syntex manufactures and sells HT.

I wonder why she forgets to mention this on her website, or in any of her HT articles.

Jim Thornton

*Hormone replacement therapy (HRT) changed to hormone therapy (HT) Jan 2016