DECISION-MAKING AND HORMONE REPLACEMENT THERAPY - A QUALITATIVE-ANALYSIS

Biomedical discourse dominates the research literature and media accou nts of menopause. Middle aged women are increasingly faced with decisi ons about hormone replacement therapy (HRT) in the context of differin g constructions of menopause and often inconclusive information. There is an apparent discrepancy between the beneficial claims made for HRT in the medical literature and the numbers of women who use it in the U.K. An educational approach has been advocated which assumes that wit h adequate information more women will take and adhere to HPT. Middle aged women's own views and opinions about medication, health and menop ause have been relatively neglected. The extent to which women use med ical discourse in discussions of menopause and the extent to which men opause has become ''medicalized'' remain unclear. This is a descriptiv e study using in-depth interviews and a qualitative methodology to inv estigate women's accounts of their decisions relating to HRT use. Nine ty-three 50 year old women were recruited from the age/sex register of a North London general practice; 45 women agreed to take part. Three main themes were identified in the women's accounts of their decisions : (1) the presence or absence of troublesome vasomotor symptoms, (2) d octors' views and advice, and (3) views toward menopause and medicatio n. There was a general preference not to take medication, particularly for menopause, which was seen as a natural process unless severe symp toms were present. Women appeared to be considering different criteria from health professionals when making decisions about HRT. Whether th ese accounts are voiced in a medical consultation will partly depend u pon the doctor's beliefs and communication skills as well as the asser tiveness of the woman herself. (C) 1997 Elsevier Science Ltd.