title: Hormone replacement therapy menopause with a better future--a survey of views on hormone replacement therapy (HRT).
abstract: OBJECTIVE
  To assess the views and prescribing practices of doctors regarding hormone replacement therapy (HRT).
  
  
  METHODS
  In April 1999, 103 doctors from a teaching hospital participated in a survey. Using a self-administered questionnaire, subjects were contacted at the departments of Internal Medicine, Family Medicine, Obstetrics and Gynaecology, and Orthopaedics.
  
  
  RESULTS
  Seventy-two percent were below 40 years of age and 67% of the respondents were male. Most doctors believed that HRT decreases the risk of subsequent osteoporosis (97%), ischaemic heart disease (77%) and depression associated with menopause (64%). Doctors generally considered menopausal symptoms (90%), premature menopause (87%), surgical menopause (85%) and osteoporotic fracture (77%) as clear indications for hormone replacement therapy. Absolute contraindications to the therapy were stated as recent breast cancer (82%) and recent endometrial cancer (84%). Among the specialities covered, there were differing views on proposed duration of HRT. It was generally believed that a pelvic examination, cervical smear and mammography were pre-requisites when initiating and monitoring HRT. Majority (69%) felt that HRT should be offered to all menopausal women, assuming no contraindications and most (73%) did discuss HRT with their patients. However, less than 10% of the menopausal patients under their care were using HRT. Those doctors not in favor of universal offering of HRT (31%) considered unreliable patient follow up to be the main reason. Females were two times more likely to discuss HRT with their patients (p = .08). Doctors who discussed HRT with their patients were four times more likely to consider HRT for themselves or their spouses (p = .13). Gynecologists were eight times more likely to prescribe HRT than non-gynecologists (p = .001).
  
  
  CONCLUSIONS
  Doctors are positively disposed to the universal offering, and use of HRT. Further studies are needed to understand a possible gap between perceived and actual prescribing practice.
authors.affiliation: Department of Community Health Sciences, Aga Khan University Hospital, Karachi.
authors.forename: S
authors.initials: S
authors.lastname: Shafi
authors.forename: Z
authors.initials: Z
authors.lastname: Samad
authors.forename: S
authors.initials: S
authors.lastname: Syed
authors.forename: A
authors.initials: A
authors.lastname: Sharif
authors.forename: M A
authors.initials: MA
authors.lastname: Khan
authors.forename: U S
authors.initials: US
authors.lastname: Nehal
authors.forename: A R
authors.initials: AR
authors.lastname: Siddiqui
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010154:Pakistan; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires