title: Menopausal symptom management and prevention counseling after the Women's Health Initiative among women seen in an internal medicine practice.
abstract: OBJECTIVE
  To describe the management of menopausal symptoms and the prevalence of prevention counseling among women who stopped hormone therapy (HT) after publication of the initial findings of the Women's Health Initiative.
  
  
  METHODS
  Telephone survey between July and September 2003 of 142 women 50 years and older, randomly selected from a large academic primary care practice, who stopped taking HT after the WHI publication, July 9, 2002 (66% response rate).
  
  
  RESULTS
  Among 142 women, the median age was 60 years, 63% were white, 52% had at least a college degree, and 60% were taking estrogen and progestin as of July 9, 2002. The majority (82%, n = 117) who stopped HT suffered some menopausal symptom: 25 restarted HT, 13 received another prescription medication, and 56 tried at least one complementary and alternative medicine. Women most commonly used soy (n = 40) or black cohosh (n = 25) for their symptoms, although less than one third of women found either of these treatments effective. Only 49% (57 of 117) of women with symptoms visited a doctor for their symptom. Few women reported receiving counseling about prevention topics after the WHI, such as risk of osteoporosis (34%), risk of heart disease (26%), diet (41%), and exercise (45%).
  
  
  CONCLUSIONS
  Most women who stopped HT after the WHI experienced some menopausal symptoms. Few women found commonly used alternative medicines effective, and few received other prescription medications. Counseling about osteoporosis and heart disease risk was infrequent after the WHI. Future studies should focus on finding safe and effective therapies for menopausal symptoms.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. mschonbe@bidmc.harvard.edu
authors.forename: Mara A
authors.initials: MA
authors.lastname: Schonberg
authors.forename: Christina C
authors.initials: CC
authors.lastname: Wee
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003376:Counseling / Q000706:statistics & numerical data*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000592:standards*; D029001:Herbal Medicine / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D008593:Menopause / Q000187:drug effects; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D016387:Women's Health