WOMENS USE OF HORMONE REPLACEMENT THERAPY FOR RELIEF OF MENOPAUSAL SYMPTOMS, FOR PREVENTION OF OSTEOPOROSIS, AND AFTER HYSTERECTOMY

Background. Hormone replacement therapy is used for the relief of meno pausal symptoms. In the United Kingdom, guidelines have been developed for the use of hormone replacement therapy in the prevention of osteo porosis, and in the United Stares of America its use has also been rec ommended for cardiovascular disease prevention. However, compliance ha s been found to be a problem, and rates of prescribing vary between ge neral practitioners. Aim. This study set out to describe the prescribi ng of hormone replacement therapy in one general practice, to enable d octors to plan future prescribing and promotion of hormone replacement therapy, taking into account constraints on its use. Method. The pati ent records of users of hormone replacement therapy were examined to c ollect data on menopausal status, reason for use, length of use, break s from therapy and reasons for stopping therapy. Women with a history of hysterectomy and with risk factors for osteoporosis were identified from the practice morbidity register. Their use of hormone replacemen t therapy was recorded. Results. Of women aged 40-59 years on the prac tice list, 348 were taking hormone replacement therapy (20%). Of 107 w omen aged under 52 years who had had a hysterectomy and bilateral ooph orectomy 76 were taking therapy (71%). Of 158 women under the age of 5 2 years who had had a hysterectomy with preservation of the ovaries 39 were taking therapy (25%). Among women taking hormone replacement the rapy for the relief of menopausal symptoms, the highest rate of use wa s among those aged 50-54 years where 93 were on therapy (24% of women in that age group in the practice). Twenty out of 47 women with a reco rded risk factor for osteoporosis were taking therapy. More than three quarters of women using hormone replacement therapy appeared to be ta king it continuously. Conclusion. The uptake of hormone replacement th erapy was found to be high for women with a surgical menopause, the gr oup most easily identifiable as at risk of osteoporosis. Women who dec ided to take therapy appeared to take it continuously, and therefore e ffectively for prevention. Rate of uptake, rather than compliance, is more likely to constrain its use in prevention.