THE CLIMACTERIC, OSTEOPOROSIS AND HORMONE REPLACEMENT - VIEWS OF WOMEN AGED 45-49

We report climacteric symptoms among women aged 45-49, and their attit udes towards HRT and osteoporosis prevention. Semi-structured question naires were administered to 481 women attending for bone density scree ning after random invitation. We recorded social class, menopausal sta tus, history of HRT exposure and climacteric symptoms, awareness of HR T and osteoporosis, and potential willingness to consider HRT before a nd after bone densitometry. In total, 294 (61%) were from non-manual s ocial classes; 338 (70%) were premenopausal, 68 (14%) postmenopausal a nd 75 (16%) uncertain; 101 (21%) were current/previous HRT users. Thre e or more climacteric symptoms were experienced by 189 (56%) of premen opausal women, compared to 64 (94%) of postmenopausal women. Most wome n had heard of HRT (96%) and osteoporosis (84%), usually from women's magazines or friends. HRT was usually prescribed for climacteric sympt oms and, in one case, for osteoporosis prevention. Side effects were r eported with most HRT preparations and affected 38% of all users. Of t he 380 (79%) women who had never taken HRT, half had concerns about su ch treatment, and few wanted it at the menopause. However, 364 (96%) s aid they would consider HRT if their bone scan suggested increased ost eoporosis risk. In conclusion, women around the menopause experience c onsiderable climacteric morbidity, but are often anxious about HRT use . Better health education might improve HRT uptake, while long-term co mpliance might be enhanced by disclosure of fracture risk.