Physicians' views and practices concerning menopausal hormone therapy.
OBJECTIVE
To examine physicians' views and practices concerning estrogen+progestogen therapy (EPT).


METHODS
Questionnaires were mailed to a random sample of physicians in the United States (US) in 2003. A total of 1614 (53.8%) surveys were returned (633 obstetricians and gynecologists (Ob/Gyns), 571 family practitioners, and 410 internists).


RESULTS
Only a minority of the physicians (16%) would offer EPT to menopausal women in the absence of menopausal symptoms (26% Ob/Gyn, 11% family practitioners, 6% internists, p<0.0001). However, many physicians (62%) believed that EPT could be offered "short term" to menopausal women with menopausal symptoms assuming no contraindications (82% Ob/Gyn, 54% family practitioners, 42% internists; p<0.0001). Irrespective of specialty, the strongest contraindications to EPT use reported by these physicians were personal history of breast cancer (93%), thrombosis (92%), cerebrovascular disease (84%), ischemic heart disease (74%), uterine cancer (73%), as well as women's subjective "concern" about breast cancer (57%). Procedures reported as always required by physicians for continuing women on EPT were breast examination (97%), mammogram (96%), blood pressure measurement (94%), and pelvic examination (91%).


CONCLUSIONS
Internists and family practitioners address more contraindications to EPT use than Ob-Gyns. Although many physicians appear to be accepting of short-term use of EPT for menopausal indications in the absence of contraindications, the majority would not prescribe it for prophylactic purposes.
Sangi-Haghpeykar
Haleh
H
Baylor College of Medicine, Department of Obstetrics and Gynecology, Houston, TX 77030, United States. halehs@bcm.tmc.edu
Poindexter
Alfred N
AN
D000075202:Contraindications; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013038:Specialization; D014481:United States