Chilet-Rosell et al. BMC Public Health 2010, 10:134 http://www.biomedcentral.com/1471-2458/10/134 display the same concern over the quantity of informa- tion available on the Internet about their products as they do over unfair publicity from their peers [18]. The limitations of our study are related to the dynamic nature of the Internet, where content may vary each time a page is updated. Furthermore, it is possible that a search carried out at any time other than January 2009, could produce other web sites on the first results page. In addition, the selection of web sites did not comprise all the information and advertising available for each HRT drug analysed, as only the web sites appearing on the first results page were selected for ana- lysis. Nevertheless, evidence suggests that users rarely look beyond the first results page [22]. Beyond the interests of pharmaceutical companies for the quality advertising of their products, and particularly in the promotion and sale of these products on the Internet, it is, as Muir Gray states, the right and obliga- tion of public health bodies in an information society to ensure that such information is not misleading in terms of health, disease and pharmaceutical therapies. To date, the health authorities have yet to make a serious move in this direction [23]. Conclusions Controlling the promotion and sale of medicines through indirect online marketing represents a challenge to European regulatory bodies. Even though pharmaceu- tical companies have committed themselves to compli- ance with codes of good practice for the promotion of medicines, deficiencies were observed regarding the identification, information and promotion of HRT medi- cations on their web pages. Unaffected by legislation, non-corporate web pages are an ideal place for indirect HRT advertising often containing misleading informa- tion. HRT can be bought online from Spain, without a medical consultation or prescription constituting a ser- ious public health issue. Additional file 1: Annex 1. List of the web sites retrieved in the search of the best selling HRT pharmaceuticals in Spain. Click here for file [ http://www.biomedcentral.com/content/supplementary/1471-2458-10- 134-S1.DOC ] Acknowledgements We want to thank Ray Moynihan for his helpful editorial comments on the draft paper and his useful ideas on focusing the paper on the risk of use of HRT and advertising in Internet. This study is funded by the Women’s Institute (Ref: 773; Expte.69/05). Author details 1Preventive Medicine and Public Health Department, Universidad de Alicante, Alicante, Spain. 2CIBER of Epidemiology and Public Health (CIBERESP), Spain. 3Department of Audiovisual Communication and Publicity Department, Universidad de Alicante, Alicante, Spain. 4Iberoamerican Page 8 of 9 Cochrane Centre, Clinical Epidemiology and Public Health Department, Hospital Sant Pau, Barcelona, Spain. Authors’ contributions ECR conceived the study and participated in the design of the study, acquisition of data from the web pages, analysis of data and coordination and draft of the paper. MML participated in the design of the study, provided knowledge on the regulation of advertising and participated on the draft of manuscript. MTRC participated in the design of the study, acquisition of data from the web pages and helped to draft the manuscript. PAC participated in the design of the study and helped to draft the manuscript. All authors read and approved the final manuscript. 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