title: Postmenopausal hormone therapy in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): who still uses it?
abstract: We aim to investigate the patterns of hormone therapy (HT) use and associated factors in women participating in the Brazilian Longitudinal Study of Adult Health.
  
  
  
  This study included 3281 naturally menopausal women of 40 to 74 years of age at enrollment to the Brazilian Longitudinal Study of Adult Health study, who answered questions regarding their use and discontinuation of HT. Prevalence rates of current and previous HT use were calculated, and a multinomial logistic regression model was constructed to simultaneously analyze the associated factors.
  
  
  
  The prevalence of HT use increased from 1995 onwards, peaking at 55.7% in 1997. A sharp decline occurred in the decade beginning in 2000, reaching 11.1% at the study baseline interview (2008-2010). Current use was associated with being ≥60 years of age (Relative Risk Ratio (RRR): 1.81; 95%CI: 1.10-2.96), divorced (RRR: 1.72; 95%CI: 1.14-2.60), or married (RRR: 2.09; 95%CI: 1.41-3.10); having a university education (RRR: 1.66; 95%CI: 1.14-2.40) or postgraduate degree (RRR: 2.45; 95%CI: 1.80-3.35); and having private health insurance (RRR: 2.86; 95%CI: 2.00-4.09). Body mass index ≥30 kg/m(2) was inversely associated with HT use (RRR: 0.37; 95%CI: 0.26-0.53) as was the presence of at least one contraindication to HT use (RRR: 0.63; 95%CI: 0.44-0.89). Of the current users ≥60 years of age, 79.1% had been using HT for at least 5 years, and 73.6% had been menopausal for at least 10 years.
  
  
  
  Although the use of HT has declined in Brazil, the women who continue using it are largely exceeding evidence-based limits of age, time since menopause, and time of use. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Estela M L
authors.initials: EM
authors.lastname: Aquino
authors.affiliation: Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz), Salvador, Bahia, Brazil.
authors.forename: Maria-da-Conceição C
authors.initials: MD
authors.lastname: Almeida
authors.affiliation: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Greice M S
authors.initials: GM
authors.lastname: Menezes
authors.affiliation: Campus Centro Oeste Dona Lindu, Universidade Federal de São João Del-Rei, Divinópolis, Minas Gerais, Brazil.
authors.forename: Roberta Carvalho
authors.initials: RC
authors.lastname: de Figueiredo
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Bensenor
authors.affiliation: Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Sotero Serrate
authors.initials: SS
authors.lastname: Mengue
authors.affiliation: Escola Nacional de Saúde Pública, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Maria de Jesus M
authors.initials: Mde J
authors.lastname: da Fonseca
authors.affiliation: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.|Centro de Diabetes e Endocrinologia do Estado da Bahia, Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil.
authors.forename: Ligia
authors.initials: L
authors.lastname: Gabrielli
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause; D012306:Risk; D013997:Time Factors
keywords: developing countries; drug use; hormone therapy; inappropriate use; pharmacoepidemiology; postmenopause