Highlights
- •The interpretation of the literature on menopause hormone therapy (MHT) has evolved enormously over the last decade.
- •Severe vasomotor symptoms were recognized by most gynecologists as an indication for menopause hormone therapy when a woman is in her 50 s.
- •This was much less so for a woman over 60 years of age.
- •Osteoporosis was much less often recognized as an indication for menopause hormone therapy, even for women in their 50 s.
Abstract
Introduction
The interpretation of the literature on menopause hormone therapy (MHT) has evolved
enormously over the last decade. In recent years, guidelines have reinstated the place
of MHT.
Aim
This survey analyzes the prescription (initiation and maintenance) of MHT in relation
to patient age and therapy indications.
Material and method
Two vignettes were sent to gynecologists working in Belgium in a random survey. One
vignette concerned the initiation of therapy for a woman who was either 52 or 62 years
old, suffering either from severe vasomotor symptoms (VSM) or from osteoporosis. The
second vignette concerned the maintenance of MHT or switching to another medication
in a woman aged 62 years who suffered either from VSM (when stopping MHT) or from
osteoporosis. The physicians were asked how they would treat these two patients.
Results
We analyzed 443 vignettes from 222 physicians.
Initiation of MHT
84% of the respondents would initiate MHT for a 52-year-old woman with VMS, whereas
only 32% would do so for a 52-year-old woman who had osteoporosis (chi square = 33;
p < 0.001). 51% would initiate MHT for a 62-year-old woman with VMS, whereas only
14% would do so for a 62-year-old woman with osteoporosis (chi square = 17; p < 0.001).
Maintenance of therapy
87% would maintain MHT for a 62-year-old woman with severe VMS and 52% would do so
for a 62-year-old woman with osteoporosis (Chi Square 31; p < 0.001).
Conclusion
VMS are recognized as an indication for MHT, but osteoporosis much less so, even for
women around the age of 50.
Keywords
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Article info
Publication history
Published online: August 05, 2019
Accepted:
July 30,
2019
Received in revised form:
July 18,
2019
Received:
July 4,
2019
Identification
Copyright
© 2019 Published by Elsevier B.V.
