Women and their doctors have been warned not to put too much faith in the power of hormone replacement as a treatment for a variety of ills suffered after the menopause, in a report by an international panel of experts.
Such therapies might still be effective in treating symptoms such as night sweats and hot flushes and stop bone loss in most older women, but recent clinical trials are said not to have demonstrated their benefit in tackling heart disease, Alzheimer's disease, depression, incontinence, and broken bones resulting from osteoporosis.
The less than rosy verdict on treatment that many women believe can help preserve their youth and health comes in a position paper on women's health and the menopause drawn up by specialists from the US, Italy, Sweden, Switzerland, Australia, and the UK, who reviewed recent evidence on HRT - which has been eagerly sought by many women through pills, patches, gels or implants.
The replacement usually consists of both oestrogen and progestin, although women who have had hysterectomies take oestrogen alone.
Observational studies, in which patients themselves decide whether to take a drug, have suggested some benefits for conditions beyond those directly linked to the menopause but the warning to doctors to be more cautious is based on evidence from randomised controlled trials which have compared results with harmless substitutes as well as hormone therapies.
The report was compiled by the National Heart Blood and Lung Institute and the National Institutes of Health, the biggest public health research centre in the world - both are in the US - and the Giovanni Loren Zini Medical Science Foundation in Italy.
It suggests that evidence of recent trials casts doubt on the perceptions that HRT protects against heart disease. It can increase risk of blood clots, does not protect against bone fractures as well as other drugs, does not slow progression of early Alzheimer's disease, and improves mood and well-being only in women suffering flushes and disturbed sleep.
Hormone replacement does seem to prevent bone loss but this resumes once women stop taking it. The British Heart Foundation said oestrogen replacement had seemed to protect women, but "it is not appropriate for everyone and we want to see more research."
The National Osteoporosis Society said it was not surprised by the report and would not be changing its advice that HRT could benefit women.
