Screening, supplements and the use of hormonal replacement therapy in postmenopausal women in a family medicine department prior to the publication of the Woman's Health Initiative report

Abstract

Background: Many guidelines and recommendations exist on the management of the menopause. Because it is not certain what women do or what management they receive in practice, we studied what was prescribed for postmenopausal women and what screening they had undergone.

Patients and methods: A retrospective chart review was conducted on all postmenopausal women between the ages of 56-59 years who had no absolute contraindications to taking hormonal replacement therapy (HRT) and were frequent enough attendees at the family health clinic to ensure that postmenopausal issues had been addressed and screening and follow up performed. The women were patients of the family medicine department at a tertiary care hospital in Saudi Arabia.

Results: Sixty-one percent had taken HRT at some time after the menopause, including 42% of Saudis and 87% of non-Saudis. Forty-six percent of all women were taking HRT at the time of the study, including 30% of Saudis and 70% of non-Saudis. Fifty-one percent of all women were taking calcium supplements, 49% were taking vitamin D supplementation, and 63% had undergone a bone mineral density evaluation. There were notable differences in percentages between Saudis and non-Saudis. Sixteen percent of all women had never had a mammogram, including 26% of Saudis and only 3% of non-Saudis.

Conclusion: Many postmenopausal women with access to medical care were not screened nor were they taking supplements in accordance with published guidelines. There was a discrepancy in the management of Saudi and non-Saudi women that could be explained partially by the high percentage of medical professionals among non-Saudi women who are more likely to actively seek medical attention. Our study showed a large proportion of women on HRT, the standard of care before the publication of the Women's Health Initiative study.

Figure 1

At the time of the study, 51% of women were taking calcium and 49% were taking vitamin D supplements, 63% had had a bone mineral density measurement, and 84% had had a mammogram performed.