Trends in menopausal hormone therapy use of US office-based physicians, 2000-2009.
OBJECTIVE
The aim of this study was to evaluate recent trends and the adoption of practice recommendations for menopausal hormone therapy (MHT) use from 2001 to 2009 by formulation, dose, woman's age, and characteristics of physicians reporting MHT visits.


METHODS
The IMS Health (Plymouth Meeting PA) National Disease and Therapeutic Index physician survey data from 2001 to 2009 were analyzed for visits in which MHT use was reported by US office-based physicians. Estimated national volume of visits for which MHT use was reported.


RESULTS
MHT use declined each year since 2002. Systemic MHT use fell from 16.3 million (M) visits in 2001 to 6.1 M visits in 2009. Declines were greatest for women 60 years or older (64%) but were also substantial for women younger than 50 years (59%) and women 50 to 59 years old (60%). Women 60 years or older accounted for 37% of MHT use. Lower dose product use increased modestly, from 0.7 M (2001) to 1.3 M (2009), as did vaginal MHT use, from 1.8 M (2001) to 2.4 M (2009). Declines in continuing systemic MHT use (65%) were greater than for newly initiated MHT use (51%). Compared with other physicians, obstetrician/gynecologists changed their practices less, thereby increasing their overall share of total MHT visits from 72% (2001) to 82% (2009).


CONCLUSIONS
Total MHT use has steadily declined. Increased use of lower dose and vaginal products reflects clinical recommendations. Uptake of these products, however, has been modest, and substantial use of MHT continues in older women.
Program on Prevention Outcomes, Stanford Prevention Research Center, Stanford School of Medicine, Stanford, CA 94305-5411, USA. sandra.tsai@stanford.edu
Sandra A
SA
Tsai
Marcia L
ML
Stefanick
Randall S
RS
Stafford
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D006176:Gynecology; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008297:Male; D008593:Menopause; D008875:Middle Aged; D009774:Obstetrics; D058007:Physicians, Primary Care; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011372:Progestins / Q000008:administration & dosage; D014481:United States; D055815:Young Adult
D004967:Estrogens; D011372:Progestins