Management of hormone replacement therapy: the Swedish experience.
OBJECTIVE
To describe the experience of Swedish physicians in the management of hormone replacement therapy (HRT).


METHODS
A postal questionnaire was sent to a sample of Swedish women aged between 46 and 62 years of age. The sample represented one woman in two from the birth cohorts 1946, 1942, 1938, 1934 and 1930.


RESULTS
A total of 5990 women were sent the questionnaire and 4525 (76%) completed and returned it. Of this sample, 21% currently used HRT and a further 20% had used it in the past. A high proportion who continued using HRT derived benefit from it which was reflected in relief from vasomotor symptoms, irritability, insomnia, vaginal dryness and muscle and joint pain. Only 27% of those trying other, non-hormonal therapy considered that they had benefited from it. The major reasons for not taking HRT was fear of side-effects, a belief that the menopause should not be interfered with, and at the recommendation of their physician. The same reasons were given by those women starting HRT but discontinuing it later.


CONCLUSIONS
The figure of 21% using HRT compares favourably with other Scandinavian countries. A high proportion of HRT is prescribed by gynaecologists reflecting that many GPs were unfamiliar with its use. When HRT is given by GPs, many favour the transdermal route. Compliance is a major problem and few women continue long enough to benefit fully. One way of minimizing this is to ensure that patients are fully informed and have any fears and misconceptions dealt with. Adverse and misleading information from the media may have to be countered. Individualization of therapy is important and should be tailored to particular age groups. Transdermal HRT may be more acceptable in some cases.
Mattsson
L A
LA
Department of Obstetrics and Gynaecology, Ostra Hospital, University of Gothenburg, Sweden.
Stadberg
E
E
Milsom
I
I
D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000706:statistics & numerical data; D005194:Family Practice; D005260:Female; D006176:Gynecology; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D013548:Sweden