A new survey of UK women taking hormone replacement therapy shows that most have not been deterred by studies linking the drug to a higher  risk of cancer, while  others who had stopped are now taking it again.

It is now two years since a major US National Institutes of Health study showed a significantly increased risk of cancer, investigators concluding that the benefit/risk ratio was not sufficient for many women to continue taking the treatment.

Since then, other studies, including the UK's Million Women Study have come to similar conclusions, and manufacturers have seen demand drop off dramatically, with global sales of Wyeth's Prempro franchise falling 32% in 2003.

Around 1.7 million women in the UK were on HRT 18 months ago, but Wyeth calculates that around a third may have stopped treatment following media coverage of the studies.

Sales in England for all combination HRT products fell 28% to £21.9 million in 2003 as the government advised doctors to review the medication on a case-by-case basis.

Clearly intent on providing a contrast to all the negative press, Wyeth commissioned NOP World to conduct a survey of 400 UK women aged between 45 and 64 or over who are currently on HRT or have stopped in the past 18 months.

The survey provides a number of insights into women's thoughts on the HRT scare, among the most notable being that negative media coverage was not the main reason for stopping treatment.; 45% of those who had stopped agreed with the statement that  "I had been on HRT for a long time and felt it was the right time to stop" while only 33% also cited the influence of media coverage.

Moreover, 21% of women who have stopped HRT in the last 18 months have now returned to treatment, agreeing with those who had never quit that effective treatment of menopausal symptoms was the main reason to take the treatment.

Nine out of ten women who had stopped experienced  a recurrence of symptoms, with more than 75% open to resuming treatment under the right circumstances.

"Recent media coverage may have made women more cautious. However, living with the often debilitating symptoms of menopause can be so awful that more women are starting to reconsider HRT as a suitable short-term option for them," said Dr Sally Hope, GP with a special interest in women's health and the menopause.

Ms Hope added: "The decision to prescribe treatment should be made based on a woman's individual needs. When used in line with current recommendations, at the lowest effective dose for the shortest duration of time, HRT can potentially change women lives. It has to be the woman's informed choice about the risks and benefits."

The survey does not differentiate between the wide range of HRT products, which studies have suggested have different risk/benefit profiles. Another arm of the US study, looking at Wyeth's oestrogen-only Premarin, was halted earlier this year after patients were found to have a higher risk of stroke. Wyeth said the study contained some good news for women, showing that it did not increase the risk of breast cancer and reduced the risk of hip fractures.

pharmafocus@pharmafile.co.uk