WOMENS CONCERNS WITH HORMONE REPLACEMENT THERAPY-COMPLIANCE ISSUES

Objective: To review the literature and attempt to define patient comp liance with hormonal replacement therapy and physician prescription of these therapies. Design: Review of selected literature. Setting: Popu lation studies and clinical trials. Patients: Postmenopausal and postc astration women. Interventions: Hormone replacement regimens. Main Out come Measures: Descriptions and compliance by patients. Results: In ad dition to the effective control of vasomotor hot flushes and atrophic genital changes in postmenopausal women, it is now well established th at the long-term use of estrogen replacement therapy (ERT) or hormone replacement therapy (HRT) with estrogen and/or progestin offers prophy laxis against osteoporosis and cardiovascular arteriosclerotic disease , notably myocardial infarction. However, despite such documentation o f benefit, it is estimated that <20% of postmenopausal women in the Un ited States have ever had ERT or HRT prescribed, <40% of those for who m such treatment has been prescribed will continue it after 1 year, an d that overall, >70% of those for whom it has been prescribed are not compliant. It appears that this lack of prescription and compliance ar e the function of both physician and patient considerations. This pape r presents reasons for such actions and reviews ways in which use can be improved.