Menopausal hormone therapy in Germany: Results of three national surveys from 1997 to 2003

Heier, Margit; Moebus, Susanne; Meisinger, Christa; Jöckel, Karl-Heinz; Völzke, Henry; Döring, Angela; Alte, Dietrich

doi:10.1016/j.maturitas.2008.10.002

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Volume 62, Issue 1 , Pages 9-15, 20 January 2009

Menopausal hormone therapy in Germany:

Results of three national surveys from 1997 to 2003

Margit Heier
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany
- Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Register, Augsburg, Germany
- Corresponding author at: Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany. Tel.: +49 89 3187 4580; fax: +49 89 3187 3667.
Susanne Moebus
- University of Duisburg-Essen, Institute for Medical Informatics, Biometry and Epidemiology, Essen, Germany
Christa Meisinger
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany
- Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Register, Augsburg, Germany
Karl-Heinz Jöckel
- University of Duisburg-Essen, Institute for Medical Informatics, Biometry and Epidemiology, Essen, Germany
Henry Völzke
- Ernst Moritz Arndt University of Greifswald, Institute of Epidemiology and Social Medicine, Greifswald, Germany
Angela Döring
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany
Dietrich Alte
- Ernst Moritz Arndt University of Greifswald, Institute of Epidemiology and Social Medicine, Greifswald, Germany

Received 6 June 2008; received in revised form 25 September 2008; accepted 2 October 2008. published online 05 November 2008.

Abstract

Objective

To determine regional variations in the prevalence and applied therapy regimes of current menopausal hormone therapy (HT) in Germany.

Methods

Three population-based surveys, analysing data of 45–74 years old women, were compared: The Study of Health in Pomerania (SHIP; 1123 participants; northeast Germany, October 1997–May 2001), Cooperative Health Research in the Augsburg Region Survey 2000 (KORA; 1253 participants; south Germany, October 1999–April 2001) and Heinz Nixdorf Recall Study (HNR; 2257 participants; west Germany, December 2000–August 2003). A standardized interview technique provided data on current medication.

Results

The age-standardized prevalence of HT was 17.0% (95% confidence interval (CI): 14.9–19.1) in SHIP, 25.9% (95% CI: 23.6–28.3) in KORA and 24.7% (95% CI: 22.9–26.4) in HNR. Mean average time of intake of HT was 5.1 (SHIP), 7.5 (KORA) and 10.1 years (HNR). The use of estrogen plus progestogen combinations was equally common in all three surveys with proportions of about 15%, the use of unopposed estrogen in KORA and HNR was twice as high as in SHIP. In all three surveys oral estradiol was taken most often. Transdermal estradiol was preferred by KORA women whereas conjugated estrogens were taken most frequently by HNR women.

Conclusions

Compared to northeast Germany HT was more often applied in the south and west of Germany. HT as long-term therapy was more common in West than in East Germany. In each study region there was a specific pattern of used HT components.

Keywords: Menopausal hormone therapy, Population-based study, Prevalence, Therapy regimes