title: Characteristics associated with initiation of hormone replacement therapy among Finnish women: A register-linkage study.
abstract: OBJECTIVE
  To investigate which patient characteristics are associated with the initiation of hormone replacement therapy (HRT) in a cohort of Finnish women.
  
  
  METHODS
  Responses to postal questionnaires distributed to a nationwide, randomly selected cohort of women in 1998, 2000, 2003, 2005 and 2010 were analyzed. The cohort members were aged 40-44 years at the beginning of the study. Information on hormone replacement therapy was received from the national prescription register. Women who started taking HRT between January 1, 1999 and December 31, 2011 were included and previous users were excluded from the analysis.
  
  
  METHODS
  Initiation of HRT was the main outcome measure. The following explanatory factors for predicting the use of HRT were examined: sociodemographic factors, personality, health behavior, physiological and mental symptoms, chronic diseases and use of psychopharmaceuticals. The associations between starting HRT and the explanatory factors were analyzed with single-predictor and multi-predictor logistic regression models.
  
  
  RESULTS
  Factors predicting that a woman would start taking HRT were: living with a partner, weak sense of coherence, BMI less than 30kg/m(2), heavy or moderate alcohol use, symptoms of hyperactivity of the sympathetic nervous system, climacteric symptoms and use of psychopharmaceuticals.
  
  
  CONCLUSIONS
  Women with a good sense of coherence can cope with climacteric symptoms without resorting to HRT. Clinicians need to bear in mind the burden of menopausal symptoms on a woman's personal and working life when HRT is being considered.
authors.affiliation: Department of Public Health, University of Turku, Turku, Finland. Electronic address: jaana.jalava-broman@utu.fi.
authors.forename: J
authors.initials: J
authors.lastname: Jalava-Broman
authors.affiliation: Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Mäkinen
authors.affiliation: Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Sillanmäki
authors.affiliation: Department of Public Health, University of Turku, Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Vahtera
authors.affiliation: Department of Public Health, University of Turku, Turku, Finland; Clinical Research Center, University of Turku, Turku, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Rautava
mesh_terms: D000328:Adult; D005260:Female; D005387:Finland; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D011795:Surveys and Questionnaires
keywords: Climacteric symptoms; Finnish women; Hormone replacement therapy