Advertisement

Journal of Behavioral Medicine

, Volume 28, Issue 1, pp 105–114 | Cite as

Initiation and Discontinuation of Hormone Therapy for Menopausal Symptoms: Results From a Community Sample

  • Hayden B. Bosworth
  • Lori A. Bastian
  • Steven C. Grambow
  • Colleen M. McBride
  • Celette Sugg Skinner
  • Laura Fish
  • Barbara K. Rimer
  • Ilene C. Siegler
Article

Abstract

Factors related to initiation and discontinuation of hormonal therapy (HT) for treatment of menopausal symptoms were examined in a community sample of 533 peri/postmenopausal women aged 45–54 by telephone three times. Over 40 variables including: sociodemographic characteristics, clinical reasons to start HT use, HT contraindications, HT attitudes/knowledge, and health behaviors were examined in logistic regression models comparing women who discontinued HT to women who continued using HT over 9 months (discontinuers) and women who initiated HT versus women who never used HT over 9 months (initiators). Increased understanding of HT, confidence, mental health symptoms, perception that menopause is natural, and having gynecological surgery were related to decreased likelihood of HT discontinuation. Increased understanding about risks of HT, vasomotor symptoms, mood symptoms, and having gynecological surgery were related to increased likelihood of HT Initiation. These findings highlight the importance of physicians discussing HT with their patients, particularly because of recent clinical trial developments.

Keywords

menopause hormonal replacement medication patient–physician communication adherence climacteric symptoms 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anarte, M. T., Cuadros, J. L., and Herrera, J. (1998). Hormonal and psychological treatment: Therapeutic alternative for menopausal women? Maturitas 29(3): 203–213.Google Scholar
  2. Avis, N. E., Stellato, R., Crawford, S., Bromberger, J., Ganz, P., Cain, V., and Kagawa-Singer, M. (2001). Is there a menopausal syndrome? Menopausal status and symptoms across racial/ethnic groups. Soc. Sci. Med. 52(3): 345–356.Google Scholar
  3. Barrett-Connor, E., Espeland, M. A., Greendale, G. A., Trabal, J., Johnson, S., Legault, C., Krtz-Silverstein, D., and Einhorn, P. (2000). Postmenopausal hormone use following a 3-year randomized clinical trial. J. Womens Health Gender-Based Med. 9(6): 633–643.Google Scholar
  4. Bastian, L. A., Couchman, C. G., Rimer, B. K., McBride, C. M., Feaganes, J. R., and Siegler, I. C. (1997). Perceptions of menopausal stage and patterns of hormone replacement therapy use. J. Womens Health 6(4): 467–475.Google Scholar
  5. Bosworth, H. B., Bastian, L. A., Kuchibhatla, M. N., Steffens, D. C., McBride, C. M., Skinner, C. S., Rimer, B. K., and Siegler, I. C. (2001). Depressive symptoms, menopausal status, and climacteric symptoms in women at midlife. Psychosom. Med. 63(4): 603–608.Google Scholar
  6. Bosworth, H. B., Bastian, L. A., and Siegler, I. C. (1998). Benefits and drawbacks to hormone replacement therapy among nursing home patients. Womens Health Issues 8(1): 53–59.Google Scholar
  7. Breslau, E. S., Davis, W. W., Doner, L., Eisner, E. J., Goodman, N. R., Meissner, H. I., Rimer, B. K., and Rossouw, J. E. (2003). The hormone therapy dilemma: Women respond. J. Am. Med. Womens Assoc. 58(1): 33–43.Google Scholar
  8. Coope, J. (1996). Hormonal and non-hormonal interventions for menopausal symptoms. Maturitas 23(2): 159–168.Google Scholar
  9. Couzi, R., Helzlsouer, K. J., and Fetting, J. H. (1995). Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J. Clin. Oncol. 13(1): 2737–2744.Google Scholar
  10. Dennerstein, L., Burrows, G. D., Hyman, G. J., and Sharpe, K. (1979). Hormone therapy and affect. Maturitas 1(4): 247–259.Google Scholar
  11. den Tonkelaar, I., and Oddens, B. J. (2000). Determinants of long-term hormone replacement therapy and reasons for early discontinuation. Obstet. Gynecol. 95(4): 507–512.Google Scholar
  12. DiMatteo, M., Hays, R. D., Gritz, E. R., and Bastani, R. (1993). Patient adherence to cancer control regimens: Scale development and initial validation. Psychol. Assess. 5: 102–112.Google Scholar
  13. Eraker, S., Kirscht, J. P., and Becker, M. H. (1984). Understanding and improving patient compliance. Ann. Intern. Med. 100: 258–268.Google Scholar
  14. Espeland, M., Bush, T. L., Mebane-Sims, I., Stefanick, M. L., Johnson, S., Sherwin, R., and Waclawiw, M. (1995). Rationale, design, and conduct of PEPI Trial. Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA 16: 3S–19S.Google Scholar
  15. Ettinger, B. (1987). Overview of the efficacy of hormonal replacement therapy. Am. J. Obstet. Gynecol. 156(5): 1298–1303.Google Scholar
  16. Ettinger, B., Pressman, A., and Silver, P. (1999). Effect of age on reasons for initiation and discontinuation of hormone replacement therapy [published erratum appears in Menopause 2000 Mar–Apr;7(2): 135]. Menopause 6(4): 282–289.Google Scholar
  17. Feldman, B., Voda, A., and Gronseth, E. (1985). The prevalence of hot flash and associated variables among perimenopausal women. Res. Nurs. Health 8: 261–268.Google Scholar
  18. Ferguson, K., Hoegh, C., and Johnson, S. (1989). Estrogen replacement therapy. A survey of women’s knowledge and attitudes. Arch. Intern. Med. 149: 133–136.Google Scholar
  19. Gass, M., Rebar, R. W., Liu, J. H., and Cedars, M. I. (1997). Characteristics of women who continue using hormone replacement therapy. Menopause 4: 19–23.Google Scholar
  20. Gold, E. B., Sternfeld, B., Kelsey, J. L., Brown, C., Mouton, C., Reame, N., Salamone, L., and Stellato, R. (2000). Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40–55 years of age. Am. J. Epidemiol. 152(5): 463–473.Google Scholar
  21. Greendale, G., Reboussin, B., Hogan, P., Barnabei, V. M., Shumaker, S., Johnson, S., and Barrett-Connor, E. (1998). Symptom relief and side effects of postmenopausal hormones: Results from the Postmenopausal Estrogen/Progestin Interventions Trial. Obstet. Gynecol. 92: 982–988.Google Scholar
  22. Griffin, S. (1995). Menopause and mood. Depression 3: 56–59.Google Scholar
  23. Hartigan, J. (1975). Clustering Algorithms, Wiley, New York.Google Scholar
  24. Hemminki, E., and McPherson, K. (1997). Impact of postmenopausal hormone therapy on cardiovascular events and cancer: Pooled data from clinical trials. Br. Med. J. 315: 149–153.Google Scholar
  25. Hosmer, D., and Lemeshow, S. (1989). Applied Logistic Regression, Wiley, New York.Google Scholar
  26. Hunter, M. (1990). Somatic experience of the menopause: A pros- pective study. Psychosom. Med. 52: 357–367.Google Scholar
  27. Janz, N. K., and Becker, M. H. (1984). The Health Belief Model: A decade later. Health Educ. Q. 11(1): 1–47.Google Scholar
  28. Jensen, L., and Hilden, J. (1996). Sociological and behavioral characteristics of perimenopausal women with an express attitude to hormone substitution therapy. Maturitas 23: 73–83.Google Scholar
  29. Kaiser, H. F. (1961). A note on Guttman’s lower bound for the number of common factors. Br. J. Stat. Psychol. 14: 1–2.Google Scholar
  30. Karakoc, B., and Erenus, M. (1998). Compliance considerations with hormone replacement therapy. Menopause 5(2): 102–106.Google Scholar
  31. Kritz-Silverstein, D., Goldani Von Muhlen, D., and Barrett-Connor, E. (2000). Prevalence and clustering of menopausal symptoms in older women by hysterectomy and oopherectomy status. J. Womens Health Gender Based Med. 9(7): 747–755.Google Scholar
  32. Kronenberg, F. (1981). Hot flashes. In Lobo, R. (Ed.), Treatment of the Postmenopausal Woman: Basic and Clinical Aspects, Raven, New York, pp. 885–907.Google Scholar
  33. Kronenberg, F. (1990). Hot flashes: Epidemiology and physiology. Ann. N.Y. Acad. Sci. 592: 52–86.Google Scholar
  34. Lindgren, R., Berg, G., Hammar, M., and Zuccon, E. (1993). Hormonal replacement therapy and sexuality in a population of Swedish postmenopausal women. Acta Obstet. Gynecol. Scand. 72: 292–297.Google Scholar
  35. Lobo, R. (1995). Benefits and risks of estrogen replacement therapy. Am. J. Obstet. Gynecol. 173: 982–990.Google Scholar
  36. McBride, C. M., Bastian, L. A., Halabi, S., Fish, L., Lipkus, I. M., Bosworth, H. B., Rimer, B. K., and Siegler, I. C. (2002). A tailored intervention to aid decision making about hormone replacement therapy. Am. J. Public Health 92(7): 1112–1114.Google Scholar
  37. Oddens, B. J., and Boulet, M. J. (1997). Hormone replacement therapy among Danish women aged 45–65 years: Prevalence, determinants, and compliance. Br. J. Obstet. Gynaecol. 104(Suppl 16): 1–3.Google Scholar
  38. Oldenhave, A., Jaszmann, L. J., Everaerd, W. T., and Haspels, A. A. (1993). Hysterectomized women with ovarian conservation report more severe climacteric complaints than do normal climacteric women of similar age. Am. J. Obstet. Gynecol. 168(3 Pt 1): 765–771.Google Scholar
  39. Park, D. (1994). Self-regulation and control of rheumatic disorders. Int. Rev. Health Psychol. 3: 189–217.Google Scholar
  40. Pearlstein, T., Rosen, K., and Stone, A. B. (1997). Mood disorders and menopause. Endocrinol. Metab. Clin. North Am. 26(2): 279–294.Google Scholar
  41. Rabin, D., Cipparrone, N., Linn, E. S., and Moen, M. (1999). Why menopausal women do not want to take hormone replacement therapy. Menopause 6: 61–67.Google Scholar
  42. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results From the Women’s Health Initiative randomized controlled trial. (2002). JAMA 288(3): 321–333.Google Scholar
  43. Rothert, M., Rovner, D., Holmes, M., Schmitt, N., Talarczyk, G., Kroll, J., and Gogate, J. (1990). Women’s use of information regarding hormone replacement therapy. Res. Nurs. Health 13(6): 355–366.Google Scholar
  44. Rymer, J., and Morris, E. P. (2000). Menopausal symptoms. Br. Med. J. 321(7275): 1516–1519.Google Scholar
  45. Salamone, L., Pressman, A. R., Seeley, D. G., and Cauley, J. A. (1996). Estrogen replacement therapy. A survey of older women’s attitudes. Arch. Intern. Med. 156: 1293–1297.Google Scholar
  46. Salthouse, T. (1991). Theoretical Perspectives in Cognitive Aging, Erlbaum, Hillsdale, NJ.Google Scholar
  47. Schmidt, P. J., Nieman, L., Danaceau, M. A., Tobin, M. B., Roca, C. A., Murphy, J. H., and Rubinow, D. R. (2000). Estrogen replacement in perimenopause-related depression: A preliminary report. Am. J. Obstet. Gynecol. 183(2): 414–420.Google Scholar
  48. Sherwin, B. (1988). Affective changes with estrogen and androgen replacement therapy in surgically menopausal women. J. Affect. Disord. 14: 177–187.Google Scholar
  49. Sinclair, H., Bond, C. M., and Taylor, R. J. (1993). Hormone replacement therapy: A result of women’s knowledge and attitudes. Br. J. Gen. Pract. 43: 365–370.Google Scholar
  50. Soares, C. N., Almeida, O. P., Joffe, H., and Cohen, L. S. (2001). Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: A double-blind, randomized, placebo-controlled trial. Arch. Gen. Psychiatry 58(6): 529–534.Google Scholar
  51. Stadberg, E., Mattsson, L. A., and Milsom, I. (1997). Women’s attitudes and knowledge about the climacteric period and its treatment. A Swedish population-based study. Maturitas 27: 109–116.Google Scholar
  52. Streiner, D., and Norman, G. R. (1995). Health Measurement Scales: A Practical Guide to Their Development and Use, 2nd ed., Oxford University Press, New York.Google Scholar
  53. Vestergaard, P., Hermann, A. P., Gram, J., Jensen, L. B., Kolthoff, N., Abrahamsen, B., Brot, C., and Eiken, P. (1998). Improving compliance with hormonal replacement therapy in primary osteoporosis prevention. Maturitas 28(3): 213–219.Google Scholar
  54. Walsh, J., Brown, J. S., Rubin, S., Kagawa, M., and Grady, D. (1997). Postmenopausal hormone therapy: Factors influencing women’s decision making. Menopause 4: 39.Google Scholar
  55. Wardell, D., and Engebretson, J. C. (1995). Women’s anticipations of hormonal replacement therapy. Maturitas 22: 177–183.Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Hayden B. Bosworth
    • 1
    • 2
    • 3
    • 4
  • Lori A. Bastian
    • 1
    • 2
    • 4
  • Steven C. Grambow
    • 1
    • 5
  • Colleen M. McBride
    • 6
    • 7
  • Celette Sugg Skinner
    • 6
    • 7
  • Laura Fish
    • 6
  • Barbara K. Rimer
    • 8
  • Ilene C. Siegler
    • 3
    • 4
    • 6
  1. 1.Center for Health Services Research in Primary CareDurham VAMCDurham
  2. 2.Department of Medicine, Division of General Internal MedicineDuke University Medical CenterDurham
  3. 3.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurham
  4. 4.Center for Aging and Human DevelopmentDuke UniversityDurham
  5. 5.Department of Biostatistics and BioinformaticsDuke University Medical CenterDurham
  6. 6.Cancer Prevention, Detection, and Control Research ProgramDuke Comprehensive Cancer CenterDurham
  7. 7.Department of Community and Family MedicineDuke University Medical CenterDurham
  8. 8.8Department of Health Behavior and Health Education, School of Public HealthUniversity of North Carolina at Chapel HillChapel Hill

Personalised recommendations