Use of hormone replacement therapy by menopausal women in six family-practice teaching clinics in Israel.
BACKGROUND
The necessity of hormone replacement therapy (HRT) remains a controversial subject, but guidelines suggest that the subject be discussed with all menopausal women.


OBJECTIVE
To determine the rate of HRT use among women cared for in family-practice, university-affiliated teaching clinics.


METHODS
Physicians from six family-practice teaching clinics enrolled all menopausal patients, aged between 50 and 70 years, registered in their practice. A detailed questionnaire was completed regarding demographic and health variables, gynecological history and the nature of HRT use.


RESULTS
In total, 682 women were invited to participate in the study; 587 (86%) participated. Some 74% of the women were married, 64% were secular and 43% stated that they performed regular exercise. Current HRT use was reported by 156 women (26.6%). Most women (83%) had been treated for over 1 year. Common indications for starting treatment were hot flushes (75%), and routine recommendation by their physician (68%). Eighty-three (14%) women were past HRT users. It was stated by 45% of never-users that HRT had never been offered to them. Current users of HRT were found to be younger than non-users (mean age 58.2 years vs. 61.5 years, p < 0.0001), more secular than traditional or religious (p < 0.0001) with more years of formal education (p < 0.0001), and more likely to be of Western or European ("Ashkenazi") origin (p < 0.0001). Current HRT users reported fewer chronic illnesses than did non-users (p = 0.001); they were more likely to report being engaged in regular exercise (p < 0.002) and were less likely to be obese (p < 0.005). In a multiple regression model, HRT use was associated with more years of formal education and a secular identity.


CONCLUSIONS
Our study found a higher proportion of women using HRT than in other Israeli studies. HRT use was more prevalent among women with improved health status and higher socioeconomic status. The most common reason given for not using HRT was that a physician had not raised the subject, indicating that physician-related factors might contribute to using HRT. Thus, comparing HRT prescribing rates in non-teaching clinics should clarify this factor.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
S
S
Vinker
B
B
Kaplan
J
J
Yaphe
O
O
Cohen
V
V
Shumla
G
G
Shapira
I
I
Shofty
E
E
Kitai
D000368:Aged; D004522:Educational Status; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005194:Family Practice; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008593:Menopause; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012044:Regression Analysis; D011795:Surveys and Questionnaires