Research Article| Volume 58, ISSUE 3, P259-268, November 20, 2007

Hormone therapy use and prescription durations of menopausal women in Taiwan: A 5 years’ National Cohort study

  • De-Jhen Kuo
    Department of Health Administration, Tzu Chi College of Technology, Hualien, Taiwan

    Institute of Health and Welfare Policy and Research Center of Health and Welfare Policy, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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  • Yue-Chune Lee
    Corresponding author at: Institute of Health and Welfare Policy, National Yang-Ming University, No. 155, Section 2, Li-Long Street, Pei-Tou District, Taipei 112, Taiwan, ROC. Tel.: +886 2 2826 7055; fax: +886 2 2823 6378.
    Institute of Health and Welfare Policy and Research Center of Health and Welfare Policy, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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  • Weng-Foung Huang
    Institute of Health and Welfare Policy and Research Center of Health and Welfare Policy, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Published:September 21, 2007DOI:



      To describe the prevalence and associated factors of hormone replacement therapy (HRT)-related utilization in a national representative fixed cohort in Taiwan.


      The study population are women aged 40 years and over in Taiwan. Our data, provided by National Health Research Institutes, are the sampled registry information of 37,315 beneficiaries of National Health Insurance from 2000 to 2004. The dependent variables were HRT-related utilizations, including physician contact, HRT utilization rate/duration/patterns (new, prevalent and discontinue users). The independent variables were age, time, prior co-morbidities and prior utilization pattern. We used generalized estimating equation (GEE) model for repeated measurement analysis.


      The outpatient contact rates for menopause syndrome were low, though the HRT prescription rate among those who have contact were high. GEE shows that age, time, prior co-morbidities/HRT utilization patterns were significantly associated with all types of HRT-related utilizations, which all declined significantly following the publications of Women's Health Initiative (WHI) in 2002. The magnitudes of reduction, though similar in 2003–2004, were greater for physician contact and HRT durations than that of HRT prescription rate for those have contacts in 2002. Besides, the percentages of new (discontinue) users have already declined (increased) since 2001 although it had not declined until 2003 for the continued users.


      WHI publications have great impact on HRT-related utilizations. However, the response of the women was quicker and much drastic than that of the physicians in 2002. Besides, the efforts of the various women's associations before WHI might have some contribution to the declined (increased) of new (discontinued) users.


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        • Writing Group for the Women's Health Initiative Investigators
        Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from Women's Health Initiative randomized controlled trial.
        JAMA. 2002; 288: 3-33
        • Million Women Study Collaborators
        Breast cancer and hormone-replacement therapy in the Million Women Study.
        Lancet. 2003; 362: 419-427
        • Lawton B.
        • Utian W.H.
        Changes in use of hormone replacement therapy after the report from the Women's Health Initiative: cross sectional survey of users.
        BMJ. 2003; 327: 845-846
        • Mishra G.
        • Kok H.
        • Ecob R.
        • Cooper R.
        • Hardy R.
        • Kuh D.
        Cessation of hormone replacement therapy after reports of adverse findings from randomized controlled trials: evidence from a British birth cohort.
        Am J Public Health. 2006; 96: 1219-1225
        • Van den Berg L.T.W.T.d.J.
        • Faber A.
        • Van den Berg P.B.
        HRT use in 2001 and 2004 in The Netherlands—a world of difference.
        Maturitas. 2006; 54: 193-197
        • Huang W.F.
        • Tsai Y.W.
        • Hsiao F.Y.
        • Liu W.C.
        Changes of the prescription of hormone therapy in menopausal women: an observational study in Taiwan.
        BMC Public Health. 2007; 7: 56
        • Hersh A.L.
        • Stefanick M.L.
        • Stafford R.S.
        National use of postmenopausal hormone therapy: annual trends and response to recent evidence.
        JAMA. 2004; 292: 47-53
        • Chang C.
        • Chang C.H.
        Menopause and hormone using experiences of Chinese women in Taiwan.
        Health Care Women Int. 1996; 17 (in Chinese): 307-318
        • Chang C.
        • Chang C.C.
        Medicalization of women's health: menopause/climacteric as an example.
        Women Gend. 1998; 9 (in Chinese): 145-185
        • Fuh J.L.
        • Wand S.J.
        • Lu S.R.
        • Juang K.D.
        • Chiu L.M.
        The Kinmen women-health investigation (KIWI): a menopausal study of a population aged 40–54.
        Maturitas. 2001; 39: 117-124
        • Chung D.T.
        • Cheng W.T.
        • Liu Y.L.
        • Cheng S.P.
        The status of hormone replacement therapy among women in the clinic of health station of Jin-San hsiang.
        J Med Sci. 2001; 21 (in Chinese): S99-S106
        • Pan H.A.
        • Wu M.H.
        • Hsu C.C.
        • Yao B.L.
        • Huang K.E.
        The perception of menopause among women in Taiwan.
        Maturitas. 2002; 41: 269-274
        • Cheng M.H.
        • Wang S.J.
        • Wang P.H.
        • Fuh J.L.
        Attitudes toward menopause among middle-aged women: a community survey in an island of Taiwan.
        Maturitas. 2005; 52: 348-355
        • Huh J.L.
        • Wang S.J.
        • Lee S.J.
        • Lu S.R.
        • Juang K.D.
        A longitudinal study of cognition change during early menopausal transition in a rural community.
        Maturitas. 2006; 53: 447-453
      1. National Health Research Institutes (NHRI). National Health Insurance Database Chinese).

        • Rosner B.
        Fundamentals of biostatistics.
        2nd ed. Harvard University Press, Boston1987 (pp. 304–305)
        • Liang K.Y.
        • Zeger S.L.
        Longitudinal data analysis using generalized liner models.
        Biometrika. 1986; 73: 13-22
      2. Taipei Association for the Promotion of Women's Right.

      3. Taiwan Women's Link.

        • Shumaker S.A.
        • Legault C.
        • Rapp S.R.
        • Thal L.
        • Wallace R.B.
        • Ockene J.K.
        • et al.
        Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women. The Women's Health Initiative Memory study: a randomized controlled trial.
        JAMA. 2003; 289: 2651-2662
        • Eden J.
        Progestin in breast cancer.
        Am J Obstet Gynecol. 2003; 5: 1123-1131
        • Ng H.T.
        The impact of hormone replacement therapy: a critical review.
        zhong hua min guo fu ai yi xue za zhi (J gynecol Oncol Rep China). 2004; 1 (in Chinese): 19-31
        • Hulley S.
        • Grady D.
        • Bush T.
        • et al.
        Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women.
        JAMA. 1998; 280: 605-613