Doctors should always offer the option of HRT – but not everyone will want it, and that’s OK | Deborah Orr

It's a dereliction of duty if doctors are failing to discuss HRT knowledgably with patients. But symptoms vary, and so do people - and if some choose to tough out the menopause without medication, then kudos to them

The National Institute for Clinical Excellence (Nice) has published new guidelines aimed at helping women and their GPs to reach an informed decision about hormone replacement therapy. Nice reckons that around a million women could currently be suffering debilitating menopausal symptoms because HRT is under-prescribed. The clear implication is that Nice experts reckon around a million women would make a different choice if they were better informed. Some might believe HRT is more risky than it really is. Others might never have had the opportunity to choose at all.

The second matter is the more straightforward. Nice says its guidelines should prove useful to GPs who aren't "expert" in HRT. Eh? Since the menopause is a condition that all of a GP's female patients will encounter, surely all GPs should be fairly expert, because they are all used to routinely laying out the options to women patients as they reach their mid-40s.