Use of Hormone Replacement Therapy by Postmenopausal Women in the United States

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Abstract

Background

The benefits and risks of hormone replacement therapy (HRT) in postmenopausal women are not fully defined, and individual characteristics and preferences may influence decisions to use this therapy. Previous studies of postmenopausal women who use HRT have been conducted in local or highly selected cohorts or have not focused on current use.

Objective

To examine sociodemographic, clinical, and psychological factors associated with current use of HRT in a national population-based cohort.

Design

Random-digit telephone survey.

Setting

Probability sample of U.S. households with a telephone.

Participants

495 postmenopausal women 50 to 74 years of age in 1995.

Measurements

Current use of HRT.

Results

Current use of HRT was reported by 37.6% of women (58.7% of those who underwent hysterectomy and 19.6% of those who did not undergo hysterectomy; P = 0.001). In multivariable analyses, use of HRT was more common among women in the South (adjusted odds ratio, 2.67 [95% CI, 1.08 to 6.59]) and West (odds ratio, 2.76 [CI, 1.01 to 7.53]) than the Northeast. Use was more common among college graduates (odds ratio, 3.72 [CI, 1.29 to 10.71]) and less common among women with diabetes mellitus (odds ratio, 0.17 [CI, 0.05 to 0.51]). Other cardiac risk factors and most psychological characteristics were not associated with HRT use.

Conclusions

Sociodemographic factors, such as region and education, may be more strongly associated with use of HRT than clinical factors, such as risk for cardiovascular disease. Future efforts should focus on understanding sociodemographic variations, defining which women are most likely to benefit, and targeting therapy to them.

Conclusions

This paper is also available at http//www.acponline.org.

Ann Intern Med.1999;130:545-553.

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