[Characteristics and determinants of initiation of premenopausal use of oral progestagens in the French E3N cohort].
OBJECTIVE
To describe the characteristics and determinants of initiation of use of progestagens alone - i.e. without concomitant use of estrogen - among French premenopausal women.


METHODS
Forty-one thousand six hundred and three women from the French E3N cohort were included in our analyses. Prevalence of use was calculated from 1992 to 2005. Determinants of progestagens alone initiation were investigated prospectively from 1992 to 2005, using multivariable Cox proportional hazards models.


RESULTS
Fifty-eight per cent of women who had reached menopause between 1992 and 2005 ever used progestagens alone during their premenopause. Between 1992 and the end of 1990s, the increase in the prevalence of progestagens alone use in our cohort was close to 50%. Initiation of progestagens alone was significantly associated with a high level of education (postgraduate compared to high-school graduate: Hazard ratio [HR]: 1.09 95% confidence interval [CI]: 1.01-1.18), with a normal body mass index (overweight and obese women compared to normal-weight women: HR=0.84, 95% CI: 0.79-0.90 and HR=0.79, 95% CI: 0.69-0.89 respectively), history of gynecological disorders (mastalgia, benign breast disease and benign uterine or ovarian disease [HR=1.38, 95% CI: 1.27-1.49, HR=1.18, 95% CI: 1.13-1.24 and HR=1.60, 95% CI: 1.52-1.68 respectively]) and with recent gynaecological screening (as measured by recently performed mammogram or Pap smear HR=1.11, 95% CI: 1.05-1.17 and HR=1.38, 95% CI: 1.27-1.49 respectively).


CONCLUSIONS
Since, at least in France, use of progestagens alone at premenopause is common, evaluation of its risks and benefits is of public health importance.
Fabre
A
A
Inserm (Institut national de la santé et de la recherche médicale), ERI 20, institut de cancérologie Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif, France.
Fournier
A
A
Mesrine
S
S
Ringa
V
V
Clavel-Chapelon
F
F
D000328:Adult; D015992:Body Mass Index; D001941:Breast Diseases / Q000453:epidemiology; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000453:epidemiology; D017697:Premenopause; D015995:Prevalence; D011372:Progestins / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D014591:Uterine Diseases / Q000453:epidemiology
D011372:Progestins