Middle-aged women should not refuse hormone replacement therapy because of the controversy over its safety, a group of experts said yesterday.

HRT has an "important role" in the treatment of menopausal symptoms and women should be advised on the balance of risks and benefits, they said. More than 300 specialists in HRT from across Britain issued the "consensus" statement in response to what many consider ill-judged warnings about its risks.

The specialists, attending a conference organised by the Royal College of Physicians of Edinburgh, rejected claims by the head of the German Commission on the Safety of Medicines comparing HRT to thalidomide, the drug given to pregnant women in the 1960s that caused birth defects. Bruno Muller-Oerlinghausen, professor of pharmacology at the Benjamin Franklin University in Berlin, said "More women have probably died from the consequences of hormone therapy than damaged children were born in the wake of the thalidomide scandal."

He was referring to a series of studies over the past two years that have shown HRT, taken by about 1.5 million women in Britain, doubles the risks of breast cancer and increases the risk of blood clots, strokes and heart attacks.

The largest of these studies, published in the Lancet in August, which followed more than one million women over five years from 1996 to 2001, calculated that HRT had caused 20,000 cases of breast cancer over the past decade in Britain.

Professor David Purdie, chairman of the conference and an adviser to the Department of Health on HRT, described Professor Muller-Oerlinghausen comments as "outrageous" and "insulting to the victims [of thalidomide]". He also rejected the claim that HRT had caused 20,000 cases of breast cancer in the UK as "utterly sensationalist". He said the conclusions of the million women study were being questioned by the international scientific community.