HRT is the most effective treatment for symptoms of the menopause, however all women should be considered on a case-by-case basis before using it, the International Menopause Society has said.

It, along with six other international societies, including the Asia Pacific Menopause Federation and the North American Menopause Society, has published a consensus statement on the appropriate use of HRT.

The menopause, sometimes referred to as the ‘change of life', refers to the end of menstruation. It is usually a gradual process. The ovaries begin to produce lower amounts of hormones, which cause menstrual periods to become irregular and eventually to stop completely. The fluctuating levels of hormones may also contribute to other symptoms, such as hot flushes and night sweats.

HRT (hormone replacement therapy) is the most effective treatment for the hormonal symptoms of the menopause. Around one in five Irish women use it.

Widespread anxiety was caused among women in 2002 after a UK Women's Health Initiative study found that HRT increased the risk of breast cancer.

However since that study was released, it has become apparent that the study group was not completely representative of women taking HRT. For example, the average age of women in the study was 63, a decade older than the age most women begin HRT.

As a result, it has since been widely accepted that HRT is still the best treatment for menopause symptoms. The seven international societies decided to come together and release this global consensus statement so that there is no confusion on the matter.

They concluded that HRT is indeed the most effective treatment for menopause symptoms such as hot flushes and sleep problems. It is also good for bone health and may reduce deaths related to heart disease.

While acknowledging the risks associated with HRT, the socieities insisted that the benefits outweigh these risks in women under the age of 60.

They pointed out that the use of HRT ‘is an individual decision in terms of quality of life and health priorities, as well as personal risk factors such as age and time since menopause'. As a result, every woman should discuss their situation fully with their doctor before undertaking the treatment.

In relation to the risk of breast cancer in women over the age of 50, they admitted that this is a ‘complex issue'. However, they said that the risk attributable to HRT ‘is small and the risk decreases after treatment is stopped'.

Current safety data does not support the use of HRT in breast cancer survivors however.

"This is an important statement, because it shows that there is really pretty broad multidisciplinary agreement on how HRT should be used, and what the risks and benefits are. These organisations represent a very broad view of women's health, and so we believe that these core recommendations represent as good a summary of the state-of-the-science as you can get," commented president of the International Menopause Society, Tobie de Villiers.

He acknowledged that when it comes to the menopause and HRT, there are ‘some uncertainties' and there are also regional differences in the use of HRT.

"But the main message is that the decision to use HRT comes down to an individual woman, in consultation with her doctor. Used properly, HRT will give significantly more benefits than harm."

Details of this statement are published in the journal of the International Menopause Society, Climacteric.