Important factors for use of hormone replacement therapy: A population-based study of Swedish women. The Women's Health in Lund Area (WHILA) Study

Objective: The aim of this study was to delineate the use of hormone replac ement therapy (HRT) among women who were born between December 2, 1935, and December 1, 1945, and living in the Lund area of southern Sweden and to an alyze factors that contribute to the acceptance and continuation of HRT. Methods: All women received a generic questionnaire pertaining to demograph ic background, lifestyle, health behavior, and climacteric symptoms and und erwent a personal interview. An interim analysis was carried out on 3,900 w omen. We mailed a hormone questionnaire to the women who were using HRT (n = 1,875). This hormone questionnaire covered, for example, menopausal statu s, complaints, and alterations in and efficacy of HRT use, as well as the r easons for discontinuing HRT use. Results: A total of 1,415 (76%) women answered the hormone questionnaire. F orty-eight percent were HRT ever users, and 32% were current users. Mean du ration of HRT use was 47 months. The most common incentives for HRT use wer e alleviation of menopausal symptoms (72%) and prevention of bone loss (50% ) and/or cardiovascular disease (31%). Forty-seven percent of HRT users rep orted that they had changed regimens at least once. HRT users had higher ed ucation, full-time work, and a higher consumption of alcohol but less consu mption of cigarettes. They reported higher frequencies of climacteric sympt oms, past histories of premenstrual syndrome, use of oral contraceptives, a nd hysterectomy. They also had a higher consumption of healthcare resources . A total of 177 women withdrew from therapy. The most common reasons for d iscontinuation of HRT were weight gain, anxiety of cancer, bleeding, breast tenderness, and emotional problems. Compared with current users, past user s had less positive as well as fewer negative effects of HRT. Several varia bles contributed to compliance, including education, full-time work, regula r exercise, low frequency of persistent climacteric symptoms, and alteratio n of regimens. Conclusion: Education, working conditions, lifestyle, interest in preventio n, and severity of the climacteric symptoms are determinants for both accep tance of and compliance with HRT. (Menopause 2000;7:273-281. (C) 2000, The North American Menopause Society.).