HRT has been linked to cancer

The advice, from the government's medicines watchdog, comes after studies showed long-term HRT use increased the risk of blood clots and breast cancer.

The Medicines and Healthcare products Regulatory Agency said urgent changes to existing treatments were not needed.

HRT is used mainly to relieve the symptoms of menopause.

Few doctors now prescribe it principally to reduce the threat of brittle bone disease in older women.

Prior to news of the link to breast cancer, an estimated 1.5 million women in the UK were taking HRT, although a substantial number have stopped in the past few months.

Lowest dose

The MHRA issued its advice following the results of the Europe-wide study into the risks and benefits of HRT, which involved one million women.

It found that women over 50 taking HRT for more than a year faced a significant rise in their risk of developing breast cancer.

Advice was issued to doctors at the time, but this has been strengthened by the latest message.

No surprise

The agency said its recommendations should come as no surprise to most clinicians.

There are other quite effective treatments for preventing brittle bone disease - in most cases they are as effective as HRT Dr Hamish Meldrum, BMA

Professor Gordon Duff, the chairman of the Committee on the Safety of Medicines (CSM), which formulated the advice on behalf of the MHRA, said: "The CSM has issued new advice on the safety of HRT as new information has become available, most recently following publication of the Million Women Study in August.

"The Committee endorses the conclusions of this review and agrees that HRT remains an effective treatment for the short-term relief of menopausal symptoms but that it should no longer be considered as the therapy of choice for preventing osteoporosis, in women over the age of 50 years.

"While this new advice does not require any urgent change in treatment, women who are currently receiving HRT as long-term prophylaxis should have their treatment reviewed at the next routine appointment.

"The CSM is keeping the safety of osteoporosis treatments, including HRT, under continual review, and will issue further advice as necessary".

It said that HRT remains an option where there is evidence that other therapies do not work.

Check-up

Women already using HRT to treat osteoporosis are advised to have their treatment reviewed at their next appointment.

Dr Hamish Meldrum, from the GPs committee at the British Medical Association, urged patients not to panic, and said that it was still appropriate to use HRT to ease severe menopausal symptoms.

"There are other quite effective treatments for preventing brittle bone disease - in most cases they are as effective as HRT.

"If they are not proving successful, or if women cannot take them because of side effects, you could consider HRT as a second-line treatment."