title: Sociodemographic and clinical factors associated with HRT use in women attending menopause clinics in Italy.
abstract: OBJECTIVE
  The aim of this analysis is to find any association between the use of hormone replacement therapy (HRT) and sociodemographic and clinical factors among women attending 54 menopause clinics in Italy.
  
  
  METHODS
  The analysis includes data relating to 17,851 women who attended one of 54 menopause clinics in Italy for general gynecological evaluations and counselling between 1995 and 1997. The characteristics of women reporting ever HRT use were compared with those of never users. The odds ratios (ORs) of HRT use were computed in relation to selected reference categories, together with their 95% confidence intervals (CIs).
  
  
  RESULTS
  Of the 17,851 women interviewed, 8539 reported ever HRT use. The mean age of the never and ever HRT users was 52.8 years and 53.7 years, respectively. Higher education was associated with an increased frequency of HRT use: in comparison with women reporting no or primary-/middle-school education, the OR of HRT use of women reporting a high-school diploma or university degree was 1.3 (95% CI 1.1-1.6). HRT use tended to be less frequently reported with increasing body mass index (BMI): in comparison with women whose BMI was < 23.4 kg/m2, the OR of HRT use in those with a BMI of 23.4-26.1 kg/m2 and > or = 26.2 kg/m2 was 0.8 (95% CI 0.8-0.9) and 0.6 (95% CI 0.5-0.7), respectively. Among the postmenopausal women, those who had undergone surgical menopause had an OR of HRT use of 1.3 (95% CI 1.2-1.4). A history of breast cancer was associated with a lower frequency of HRT use (OR 0.3, 95% CI 0.2-0.4). Likewise, a history of thromboembolic disease (OR 0.5, 95% CI 0.4-0.7) or myocardial infarction (OR 0.7, 95% CI 0.6-0.9) was associated with a lower frequency of HRT use.
  
  
  CONCLUSIONS
  In our study population, the variable most closely related to HRT use was education/social class, thus underlining the impact of information campaigns on HRT and women's health. Among the medical determinants, our analysis indicates that a history of myocardial infarction, thromboembolic disease or breast cancer is associated with less frequent use of HRT.
authors.affiliation: Departments of Obstetrics and Gynecology, Instituto Mario Negri, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pansini
authors.forename: A B
authors.initials: AB
authors.lastname: Bacchi Modena
authors.forename: D
authors.initials: D
authors.lastname: de Aloysio
authors.forename: M
authors.initials: M
authors.lastname: Gambacciani
authors.forename: M
authors.initials: M
authors.lastname: Meschia
authors.forename: F
authors.initials: F
authors.lastname: Parazzini
authors.forename: G
authors.initials: G
authors.lastname: Sciacchitano
authors.forename: R
authors.initials: R
authors.lastname: di Micco
authors.forename: E
authors.initials: E
authors.lastname: Peruzzi
authors.forename: G
authors.initials: G
authors.lastname: Maiocchi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D005260:Female; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D007558:Italy / Q000453:epidemiology; D008593:Menopause; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D016387:Women's Health