Knowledge, attitudes and management strategies in Scandinavia concerning hormone replacement therapy - A comparison between gynecologists in Denmark,Norway and Sweden

Objectives: To describe and compare attitudes, knowledge and management str ategies concerning the prescription of hormone replacement therapy (HRT) be tween gynecologists from three Scandinavian countries. Design and methods: In a cross-sectional study gynecologists in Denmark (n = 386), Norway (n = 475) and Sweden (n = 1323) were invited by letter to complete and return an enclosed questionnaire. Then 1653 of the 2184 (76%) contacted gynecologist s completed and returned the questionnaire. Results: of the 1653 Scandinavi an gynecologists, 42% offered HRT to all women provided there was no contra indication, while 58% recommended HRT to selected women after considering t he advantages and disadvantages of HRT. In Norway and Sweden, the proportio n of gynecologists routinely prescribing HRT for women without contraindica tions increased with age and in the oldest age group of gynecologists ( > 5 5 years) 49 and 56%, respectively, recommended HRT to all women. The gyneco logists were unanimous in their choice of the type of HRT for perimenopausa l women as 94% preferred cyclical or sequential combined (estrogen/progesto gen) treatment or estrogen monotherapy (orally or transdermally) for hyster ectomized women (95%). For postmenopausal women, 75% of the gynecologists o ffered continuous combined HRT while cyclical combined therapy was chosen b y 15% of the gynecologists. No significant differences were found between p hysicians in the three countries regarding indications and contraindication s to HRT Conclusion: Scandinavian gynecologists are generally well informed concerning HRT and liberally recommend HRT for women without contraindicat ions. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.