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Influences of hormone replacement therapy on postmenopausal women's health perceptions

Blümel, Juan E. MD, PhD1; Castelo-Branco, Camil MD, PhD2; Kerrigan, Nicolas4; Cancelo, María J. MD, PhD3; Blümel, Bernardita4; Haya, Javier MD, PhD5; Flores, Mariana4; Carvajal, Maria Carolina4; Sarrá, Salvador MD, PhD1


Objective: To assess the beliefs of climacteric women regarding their health, menopause, and hormone replacement therapy (HRT).

Design: Medical students asked to interview 526 healthy women, ranging from 40 to 64 years of age, between January and February of 2002. Of that number, 26 (4.9%) declined to participate in the interview. Thus, 500 women were interviewed about their beliefs and perceptions regarding their quality of life and health risks, as well as their opinions on menopause and HRT.

Results: The mean age of the sample was 53.3 ± 6.2 years; 83.4% were postmenopausal, and 18.8% were HRT users. Of the women interviewed, 38.6% believed that their health was good. Although 78.8% thought that cancer is the main cause of death, 64% of them considered themselves to be at high risk for cardiovascular disease and osteoporosis. Most (64%) believed that menopause deteriorates the quality of life and that it increases cardiovascular risk (52.4%) and osteoporosis (72.0%). The HRT users perceived that they had better health status (48.9% v 36.2%, P < 0.02) and smaller cardiovascular risk (54.3% v 66.3%, P < 0.04) than did the nonusers; however, they ignored the preventive effect of estrogens in osteoporosis.

Conclusions: Women believe that menopause deteriorates their health. The HRT users perceived themselves to be healthier and to have a smaller risk for cardiovascular disease.

The climacteric period implies for most women an impairment in the quality of life and an increase in the risk of contracting chronic disorders such as cardiovascular disease and osteoporosis. 1–5 However, besides the hormonal changes related to menopause, the risk of developing these diseases is to a great extent determined by lifestyle, such as sedentariness and smoking. 6,7 Nowadays, to improve postmenopausal women's health, attitudes that diminish risk factors and the use of hormone replacement therapy (HRT) have been emphasized. 8

There is a lack of knowledge among middle-aged women about long-term consequences of menopause and the benefits and inconveniences of HRT. 9,10 In the future, the ability to implement preventive strategies will be determined by women's perception of their relative risks for developing diseases and their beliefs about available therapies and the capabilities of these to diminish their risks and to offer a positive cost-benefit relationship. 11,12

The present study was designed to assess the beliefs and perceptions of climacteric women regarding their quality of life and cardiovascular and osteoporosis risks, as well as their opinions on the relationship of these conditions with menopause and HRT.

From the 1Fundación PROSAM, Hospital Barros Luco-Trudeau, Departmento Medicina Sur. Facultad Medicina, Universidad de Chile, Santiago, Chile; 2Institut Clínic de Ginecologia, Obstetrícia i Neonatología, Hospital Clinic, Barcelona, Spain; 3Hospital General Universitario, Guadalajara, Spain; 4Alumnos de Medicina, Universidad de los Andes, Santiago, Chile; and 5Servicio de Ginecología y Obstetricia, Hospital Santa Cristina, Madrid, Spain.

Received August 5, 2002; revised and accepted October 30, 2002.

Address reprint requests to Camil Castelo-Branco, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Hospital Clínic Villarroel 170 08036 Barcelona, Spain. E-mail:

©2003The North American Menopause Society