Revised key messages for hormone replacement therapy from the New Zealand Guidelines Group

The publication of the Women's Health Initiative Study in 2002 has led to changes in the advice for women considering hormone replacement therapy (HRT) use. Along with other organisations worldwide, the New Zealand Guidelines Group (NZGG) revised their key messages for the appropriate prescribing of HRT. Long-term HRT use was not recommended, nor was the use of HRT for the prevention of coronary heart disease and stroke. While acknowledging the effectiveness of HRT for relief of menopausal symptoms, the group felt that women needed to be informed of the potential risks. Methodological criticisms of Women's Health Initiative (WHI) are discussed along with suggestions of how the study findings may be used for individual decision-making. In addition to presenting the new advice from the NZGG, the present paper compares these findings with other international bodies and seeks to present some consensus that may help decision-making for women who are symptomatic at menopause.