Changing use of hormone therapy among minority women since the Women's Health Initiative

Objective: There has been a significant shift in the use of hormone therapy (HT) among nonminority women since the publication of results of the Women's Health Initiative (WHI). Little is known about how the WHI results affected minority populations. This survey measured patterns of HT use among inner city women after publication of the WHI results, identified factors involved in the decision to continue or discontinue HT, and characterized the symptom burden and the experience of women who attempted to discontinue HT. Design: We conducted a cross-sectional survey of 101 English- and Spanish-speaking women in an inner city general internal medicine clinic from August 2003 to April 2004. All women had been taking HT at the time of the publication of the WHI results. The survey included questions on patient-reported experience with HT, symptoms of menopause, and use of alternative treatments. Results: Overall, 101 of 142 (71%) eligible women agreed to participate. The mean age of participants was 60 years; 43% were African American and 46% were Hispanic. The mean duration of HT use was 9.6 years. Three quarters (74%) had heard about the WHI findings, and 87% had attempted to stop taking HT after their publication. The most common reason for attempting to stop HT was concern about an increased risk of cancer or a general increase in risk to health. Of those who stopped HT, the vast majority (85%) reported vasomotor symptoms, and 26% restarted HT, mostly to treat those symptoms. Conclusions: Nearly all minority women in this small sample attempted to stop HT use after the results of the WHI were published. Restarting HT for treatment of symptoms was common.

[1]  R. Adams,et al.  The American College of Obstetricians and Gynecologists , 2018, Obstetrics & Gynecology.

[2]  A. LaCroix,et al.  The Herbal Alternatives for Menopause (HALT) Study: background and study design. , 2005, Maturitas.

[3]  P. Schnatz,et al.  Pilot study of menopause symptoms in a clinic population , 2005, Menopause.

[4]  E. Greiser,et al.  The impact of the Women's Health Initiative Randomized Controlled Trial 2002 on perceived risk communication and use of postmenopausal hormone therapy in Germany , 2005, Menopause.

[5]  D. Wysowski,et al.  Use of menopausal hormones in the United States, 1992 through June, 2003 , 2005, Pharmacoepidemiology and drug safety.

[6]  I. Zuckerman,et al.  The impact of the Women's Health Initiative on hormone replacement therapy in a Medicaid program. , 2004, Journal of women's health.

[7]  K. Margolis,et al.  The impact of the Women's Health Initiative on discontinuation of postmenopausal hormone therapy: the Minnesota Heart Survey (2000-2002). , 2004, Journal of women's health.

[8]  Laura B. Hansen,et al.  Impact of the Women's Health Initiative Trial Results on Hormone Replacement Therapy , 2004, Pharmacotherapy.

[9]  Karla Kerlikowske,et al.  Changes in the Use of Postmenopausal Hormone Therapy after the Publication of Clinical Trial Results , 2004, Annals of Internal Medicine.

[10]  R. Stafford,et al.  National use of postmenopausal hormone therapy: annual trends and response to recent evidence. , 2004, JAMA.

[11]  B. Ettinger,et al.  Effect of the Women's Health Initiative on Women's Decisions to Discontinue Postmenopausal Hormone Therapy , 2003, Obstetrics and gynecology.

[12]  A. Tosteson,et al.  Predictors of Difficulty When Discontinuing Postmenopausal Hormone Therapy , 2003, Obstetrics and gynecology.

[13]  N. Keenan,et al.  Severity of menopausal symptoms and use of both conventional and complementary/alternative therapies , 2003, Menopause.

[14]  A. Dowell,et al.  Changes in use of hormone replacement therapy after the report from the Women's Health Initiative: cross sectional survey of users , 2003, BMJ : British Medical Journal.

[15]  C. Kooperberg,et al.  Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. , 2002, JAMA.

[16]  Refractor Information , 2001, The Lancet.

[17]  E. Barrett-Connor,et al.  The North American Menopause Society 1998 Menopause Survey: Part II. Counseling About Hormone Replacement Therapy: Association With Socioeconomic Status and Access to Medical Care , 2000, Menopause.

[18]  Arleen F. Brown,et al.  Ethnic differences in hormone replacement prescribing patterns , 1999, Journal of General Internal Medicine.

[19]  J. Grisso,et al.  Racial differences in menopause information and the experience of hot flashes , 1999, Journal of General Internal Medicine.

[20]  P. Gorelick,et al.  The recruitment triangle: reasons why African Americans enroll, refuse to enroll, or voluntarily withdraw from a clinical trial. An interim report from the African-American Antiplatelet Stroke Prevention Study (AAASPS). , 1998, Journal of the National Medical Association.

[21]  D. Blumenthal,et al.  Low rates of hormone replacement in visits to United States primary care physicians. , 1997, American journal of obstetrics and gynecology.

[22]  J. Grisso,et al.  Ovarian Aging and Hormone Replacement Therapy: Hormonal Levels, Symptoms, and Attitudes of African-American and White Women , 2006, Journal of General Internal Medicine.

[23]  M. Stefanick,et al.  Recommendations for estrogen and progestogen use in peri-and postmenopausal women: October 2004 position statement of The North American Menopause Society. , 2004, Menopause.

[24]  B. Rimer,et al.  The hormone therapy dilemma: women respond. , 2003, Journal of the American Medical Women's Association.

[25]  E. Eisenberg,et al.  Factors Affecting Access to Menopause Information , 2000, Menopause.

[26]  E. Moy,et al.  Racial differences in estrogen use among middle-aged and older women. , 1998, Women's health issues : official publication of the Jacobs Institute of Women's Health.