HRT dose

Foot Notes

1. IMS Updated Recommendations on postmenopausal hormone therapy. Climacteric 2007:10;181-194.
2. British Menopause Society Council Consensus Statement. Alternative and Complementary Therapies. 5 June 2007. http://www.thebms.org.uk/statementcontent.php?id=2
3. Medicines and Healthcare products Regulatory Agency (MHRA) Drug Safety Update. Vol 1 Issue 2 September 2007.
4. Rossouw JE et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA 2007; 297:1465-77.

OK

The dose of hormones used in HRT should be chosen according to the individual woman’s needs in order to relieve postmenopausal symptoms. The latest recommendations¹ advocate using the lowest dose that control symptoms satisfactorily.

Low dose HRT

For many years it was assumed that when taken orally as a tablet, the dose of oestrogen needed for symptom relief and adequate protection of bones was 2.0mg 17ß-estradiol (a type of oestrogen widely used in HRT). Therefore, this was considered a standard dose. More recent research has shown that effective symptom relief and osteoporosis prevention can be achieved with even lower doses, e.g. 1.0mg.

The benefit of low dose therapy is that it shows similar efficacy to higher doses but has fewer side-effects. In future, ultra low doses are likely to be used. These will be just a quarter of the old standard dose, i.e., 0.5mg.

Additionally, as oestrogen doses have been lowered, the doses of progestogen have been minimised accordingly.

The International Menopause Society (IMS) recommends¹ treatments containing low / ultra low dose oestrogen and progestogen because:

• They appear to maintain benefits for symptom relief and osteoporosis whilst minimising side effects and risks.
• They help most women maintain a good quality of life.

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