Ms Rima Patel, 48, senior vice president in a leading pharma company, slated to be the next president of her flagship division, had to take pre-mature retirement because of her hot-flushes which embarrassed her no end at important meetings. Ms Patel had been recommended HRT at the time of her hysterectomy (with ovaries too removed) 3 yr ago. She had vehemently refused HRT because she felt it was not warranted. If this is the state of a pharma VP, what about others?

Ms Bharti Mhatre, 52, had a violent bout of sneezing and fractured 3 of ribs. Ms Bharti suffered from osteoporosis, one of the effects of menopause. Even she had rejected the offer of HRT.

Both these are real-life cases and not a figment of imagination. Doctors right across India are offering HRT, but our patients, riddled with myths, reject HRT without even a serious consideration.

HRT provides the most effective way of managing problems associated with the menopause. It gives dramatic relief of symptoms and protection from heart disease, stroke and osteoporosis. But like any medication, HRT is not risk free. The decision to begin treatment depends on a woman's medical history, her symptoms and her risk of bone loss and cardiovascular disease. Some women are less likely to develop problems due to low estrogen. Others choose not to use hormones.