Building Knowledge About the Menopausal Transition: The SMWHS Project: Influences on Decisions to Use Hormone Replacement Therapy

2.50
Hdl Handle:
http://hdl.handle.net/10755/157987
Type:
Presentation
Title:
Building Knowledge About the Menopausal Transition: The SMWHS Project: Influences on Decisions to Use Hormone Replacement Therapy
Abstract:
Building Knowledge About the Menopausal Transition: The SMWHS Project: Influences on Decisions to Use Hormone Replacement Therapy
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Smith-DiJulio, Kathleen, RN, MA
P.I. Institution Name:University of Washington School of Nursing
Title:Research Scientist
Contact Address:Box 357262, Seattle, WA, 98195-7262, USA
Contact Telephone:206-616-4770
Co-Authors:Ellen S. Mitchell, Nancy Fugate Woods
Introduction: Women have used hormone replacement therapy (HRT) during the menopausal transition (MT) to relieve symptoms and prevent the adverse sequelae of an estrogen deficiency state. Women have declined HRT because of uncertainty about whether the benefit outweighed the harm. Findings from the Women's Health Initiative (WHI) confirmed that the health promotion benefits of HRT were overstated, and not worth the health risks associated with use. Purpose: The purpose of this study was to describe reasons women in the Seattle Midlife Women's Health Study (SMWHS) gave for both using and not using HRT and to determine if WHI findings had an effect on those reasons. Methods: The sample consisted of a subset of women from SMWHS with intact uteri and ovaries; not pregnant or receiving chemotherapy, tamoxifen or radiation; in late MT (defined according to the method of Mitchell, Woods and Mariella), or postmenopausal and not on hormones, or taking HRT, who returned health questionnaires in either 1999, 2001 or 2003 (n=124). The questionnaire elicited reasons for taking, not taking and discontinuing HRT as well as experiences taking HRT. Descriptive statistics illustrate the factors that influence decisions about using HRT and the effect of HRT on symptoms. Results: The percent of women taking HRT decreased from 49% in 1999 to 35% in 2003. More women took HRT to relieve MT symptoms of hot flashes and vaginal dryness (70-75%) than to prevent disease (49-54%). HRT seemed effective for hot flashes with 75% of women reporting fewer and less severe hot flashes. Yet only 24% of women planned to take HRT only until symptoms improved. 46% expected to take it for the rest of their lives. Reasons for not taking HRT were affected by WHI findings. Concerned about news reports as a reason to not take HRT increased from 20% in 1999 to 66% in 2003; benefit risk imbalance increased from 39% to 86%; worry about cancer from 37% to 73%, concerns about side effects from 35% to 68%, and viewing menopause as natural from 29% to 59%. Advice against taking estrogen increased from 13% to 36%. Unlike previous studies, women in this sample indicated they had enough information to make a decision about HRT use; yet, across the 6 years, 25% indicated their physician never discussed HRT as an option. Implications: These data suggest that published reports of the findings of the WHI changed women's thinking about reasons to not take HRT and that their thinking was influenced by news reports as much or more than by health care encounters. With this awareness, nurses can design health promotion activities for women in the MT creatively; not restricted to conventional, system-constrained approaches.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBuilding Knowledge About the Menopausal Transition: The SMWHS Project: Influences on Decisions to Use Hormone Replacement Therapyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157987-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Building Knowledge About the Menopausal Transition: The SMWHS Project: Influences on Decisions to Use Hormone Replacement Therapy</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Smith-DiJulio, Kathleen, RN, MA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Washington School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Research Scientist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Box 357262, Seattle, WA, 98195-7262, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">206-616-4770</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ksdj@u.washington.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Ellen S. Mitchell, Nancy Fugate Woods</td></tr><tr><td colspan="2" class="item-abstract">Introduction: Women have used hormone replacement therapy (HRT) during the menopausal transition (MT) to relieve symptoms and prevent the adverse sequelae of an estrogen deficiency state. Women have declined HRT because of uncertainty about whether the benefit outweighed the harm. Findings from the Women's Health Initiative (WHI) confirmed that the health promotion benefits of HRT were overstated, and not worth the health risks associated with use. Purpose: The purpose of this study was to describe reasons women in the Seattle Midlife Women's Health Study (SMWHS) gave for both using and not using HRT and to determine if WHI findings had an effect on those reasons. Methods: The sample consisted of a subset of women from SMWHS with intact uteri and ovaries; not pregnant or receiving chemotherapy, tamoxifen or radiation; in late MT (defined according to the method of Mitchell, Woods and Mariella), or postmenopausal and not on hormones, or taking HRT, who returned health questionnaires in either 1999, 2001 or 2003 (n=124). The questionnaire elicited reasons for taking, not taking and discontinuing HRT as well as experiences taking HRT. Descriptive statistics illustrate the factors that influence decisions about using HRT and the effect of HRT on symptoms. Results: The percent of women taking HRT decreased from 49% in 1999 to 35% in 2003. More women took HRT to relieve MT symptoms of hot flashes and vaginal dryness (70-75%) than to prevent disease (49-54%). HRT seemed effective for hot flashes with 75% of women reporting fewer and less severe hot flashes. Yet only 24% of women planned to take HRT only until symptoms improved. 46% expected to take it for the rest of their lives. Reasons for not taking HRT were affected by WHI findings. Concerned about news reports as a reason to not take HRT increased from 20% in 1999 to 66% in 2003; benefit risk imbalance increased from 39% to 86%; worry about cancer from 37% to 73%, concerns about side effects from 35% to 68%, and viewing menopause as natural from 29% to 59%. Advice against taking estrogen increased from 13% to 36%. Unlike previous studies, women in this sample indicated they had enough information to make a decision about HRT use; yet, across the 6 years, 25% indicated their physician never discussed HRT as an option. Implications: These data suggest that published reports of the findings of the WHI changed women's thinking about reasons to not take HRT and that their thinking was influenced by news reports as much or more than by health care encounters. With this awareness, nurses can design health promotion activities for women in the MT creatively; not restricted to conventional, system-constrained approaches.</td></tr></table>en_GB
dc.date.available2011-10-26T20:23:53Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:23:53Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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