One-Third of Menopausal Women Still Undecided About Using Hormone Replacement Therapy

From the WebMD Archives

Dec. 10, 1999 (Minneapolis) -- If you're a woman in midlife and are still undecided about using hormone pills, you're not alone. According to a new study, one-third of women who are experiencing menopause have not made up their minds about using hormone replacement therapy (HRT). Another research team decided to find out why. The conclusions from both studies appear in the December edition of the journal Women's Health Issues.

"The vast majority of American women regard menopause as a natural part of growing older," write Andrea Z. LaCroix, PhD, and colleagues from Group Health Cooperative of Puget Sound in Seattle. Twenty-seven million American women aged 40-54, and nearly 57 million aged 55 and older, face decisions about long-term HRT and alternative preventive strategies. "When it comes to considering the balance of risks and benefits for individual women, one size does not fit all," LaCroix says.

And for good reason. "The uncertainties about using HRT are numerous, and women's decisions are highly complex because of the varying risks, values, and preferences, and because the scientific evidence of benefits and risks continues to evolve," the researchers write. While some studies have shown that HRT reduces the risk of osteoporosis, heart disease, Alzheimer's disease, and colon cancer, other studies have shown hormone therapy increases the risk of uterine cancer. The relation of HRT to breast cancer risk remains uncertain.

However, women may not be getting the information on the risks and benefits of HRT that they need to make informed decisions, according to LaCroix and her team. Donna Shoup, MD, at Women's Hospital in Los Angeles, agrees. "[For example], although the media emphasizes breast cancer risks, women actually have much greater risk of cardiovascular or heart disease," she tells WebMD. "This is where [HRT] is beneficial."

Through surveys with physicians, LaCroix and her team found that most of them agreed that HRT reduces risk of osteoporosis or heart disease. And while close to one-third of doctors agreed that a strong scientific case has been made that HRT increases risk of breast cancer, more than half of them disagreed.

Across the country at the Durham (N.C.) VA Medical Center, Lori Bastian, MD, MPH, and her colleagues interviewed more than 300 menopausal women. They found that one-third of them were undecided about using HRT, and most of these women had just begun menopause. Researchers also learned that women who were undecided were more likely to be less satisfied with information they received from their health clinic about menopause and HRT, compared with those who had already made their decision.

So what's a woman to do? "It's not our intention that every women use HRT, but it's a very important decision, so I would like to see more women make a decision, one way or the other," Bastian tells WebMD. "What we found is that undecided women are an important group that just need help in making a choice." As a solution, Bastian says, "women need to ask more questions and get more information -- from health care pamphlets, the Web, and health educators, and nurses."

Vital Information:

  • A new study shows that one-third of women going through menopause have not yet made a decision about using hormone replacement therapy (HRT).
  • There are many uncertainties with HRT, which is shown to decrease the risks of osteoporosis, heart disease, Alzheimer's disease, and colon cancer, while it increases the risk of uterine cancer, and it's association with breast cancer remains undetermined.
  • Many women who had not yet made up their mind said they were less satisfied with the HRT information they had received from their health clinic.