|
Hormone
replacement therapy : prevalence, compliance and the 'healthy
women' notion
A.H. MacLennan, D.H, Wilson* and A.W. Taylor*
Department of Obstetrics and Gynaecology, University of
Adelaide; and *Behavioural Epidemiology Unit, Public and
Environmental Health Service, South Australian Health Commission,
Adelaide, South Australia
Objectives
The objective of this study was to assess the current
trends of hormone replacement therapy (HRT) use, including
rates of use, length of use, continuation rates and characteristics
of users and non-users and to examine the hypothesis that
'healthy women' are more likely to be users of HRT. Design
and methods Analysis was carried Out of three representative
South Australia's population studies in 1991, 1993 and 1995
comprising 3019, 3004 and 3016 personal interviews, respectively.
Results Current use (and ever-use) of HRT in all
women aged 50 years and over rose from 13.2% (26.7%) in
1991, to 21.2% (31.9%) in 1993 and 26.0% (40.5%) in 1995.
Highest use is now in the 55-59 year age group where, in
1995, current use was 50.9% and ever-use was 69.0%. Median
compliance rates with HRT rose from 24 months in 1991 to
60 months in 1995 for current users age 50 years old age
or above. The pattern of increasing use of HRT is not consistent
across age groups. Analysis of the 1995 data show that,
in contrast with increasing rates of current use in women
over 55 years, there was no overall change in rates for
women below this age. There were no statistically significant
differences in health indicators, e.g. blood pressure, smoking,
cholesterol level or body mass index between users and non-users
of HRT. However, users reported significantly higher rates
of previous osteoporosis and hysterectomy. Conclusions
Prevalence rates of HRT use are increasing together with
compliance rates and this may reflect increased confidence
with HRT therapy. Users of HRT have an increased rate of
mammography compared to non-users and this may contribute
to earlier detection and, therefore, increased estimates
of breast cancer in HRT users. There was no support from
the 1995 data for a 'healthy women' hypothesis among HRT
users.
|