LONGITUDINAL PATTERNS AND CORRELATES OF HORMONE REPLACEMENT THERAPY USE IN MIDDLE-AGED WOMEN

Patterns of hormone replacement therapy (HRT) use over time and predic tors of initiating or discontinuing use were examined in a lingitudina l study. A cohort of 2,425 women aged 45-55 years identified from a po pulation-based random survey in Massachusetts in 1981-1982 was followe d by six telephone interviews, 9 months apart. Cohort participants wer e either premenopausal (66.8%) or in early perimenopause (33.2%). Duri ng the study, prevalence of use was low overall (12.3%) and was consid erably higher for surgical menopause (45%) than for peri- (9.3%), natu ral (4.5%), or premenopause (1.5%). Predictors of HRT uptake and disco ntinuation (from time t - 1 to time t) were examined by repeated-measu res logistic regression, stratified by surgical status. For surgical m enopause, the only significant predictor of HRT uptake was recent surg ery (odds ratio = 4.4; 95% confidence interval 2.73-7.22), while for n onsurgical subjects, menopausal status (primarily perimenopause), prio r use of HRT, health care utilization, hot flashes, alcohol consumtion , regular exercise, and leaner body mass were all significant predicto rs of uptake. Discontinuing HRT was inversely associated with surgical and perimenopause and positively related to prior short-term use and health care utilization. Nonsurgical HRT users had a somewhat more fav orable cardiovascular risk profile than did nonusers.