Determinants of hormone replacement therapy among postmenopausal women enrolled in the French GAZEL cohort

Abstract

Although the efficacy of hormonal replacement therapy (HRT) regarding numerous consequences of menopause is proven, its prevalence of use is low, as is compliance with the prescribed treatment. The aim of this work was to study the factors influencing a woman's decision to take HRT by analyzing the determinants of HRT use of at least 6 months' duration among post-menopausal women working for a French company and enrolled in a cohort study. Special attention was paid to the women's expectations of HRT. We compared two groups of women: 113 current HRT users who had been users for at least 6 months and 101 never users. Among the 113 current users, the most frequent treatment was a combination of oestrogen and progestin (86%). The determinants of HRT use for at least 6 months included a prior spinal radiograph, which showed a significant relationship with the use of hormone treatment (odds ratio (OR) 2.4; 95% confidence interval (CI) 1.2-4.7), a current marriage (OR 2.5; 95% CI 1.3-5.1) and previous hot flushes (OR 2.4; 95% CI 1.2-4.9). The strongest determinant was an expectation that HRT would prevent osteoporosis (OR 5.0; 95% CI 2.2-11.6). In this population concern about osteoporosis appears to be an important determinant of HRT use. Our results underline the importance of the diffusion of information among physicians and women about HRT's benefits, especially its efficacy in preventing osteoporosis.