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Use of conventional and complementary health care during the transition to menopause: longitudinal results from the Study of Women's Health Across the Nation (SWAN)

Bair, Yali A. PhD1; Gold, Ellen B. PhD2; Azari, Rahman A. PhD3; Greendale, Gail MD4; Sternfeld, Barbara PhD5; Harkey, Martha R. PhD6; Kravitz, Richard L. MD, MSPH1


Objective: Women beginning the transition to menopause now have access to complementary and alternative therapies (CAM) that were not universally available in the past. Little is known about the association between CAM use and the use of conventional health care during menopause. We investigated the longitudinal association between use of CAM therapies and utilization of conventional health care in a large, multiethnic sample of midlife women who were enrolled in the cohort phase of the Study of Women's Health Across the Nation (SWAN).

Design: We used generalized estimating equations, repeated measures modeling to examine the association between CAM use and the yearly number of conventional health-care contacts, adjusting for relevant covariates, during a two-year period. CAM use was evaluated longitudinally as continuous, incident (no CAM use at baseline), sporadic, or no use during the study period.

Results: Relative to nonusers, continuous CAM users had more conventional health-care contacts (β 0.14, 95% CI 0.06, 0.21). Incident users and sporadic users also showed an excess in conventional health-care contacts (β 0.14, CI 0.06, 0.22) and (β 0.09, CI 0.01, 0.16), respectively. Ethnicity was independently associated with health-care contacts. Relative to white women, Japanese women had fewer contacts (β −0.18, CI −0.31, −0.05).

Conclusions: Despite being a generally healthy, well-educated and high-income population with good access to health care, CAM users were using more of both conventional and alternative health-care resources than women who did not use CAM. These findings have practical implications for conventional health-care practitioners, allied health professionals and CAM practitioners.

In Brief

This study investigated the association between the use of complementary and alternative medicine (CAM) and the use of conventional health care over a period of 3 years in a large, multiethnic group of women undergoing the transition to menopause. Rather than replacing conventional care with alternatives. CAM users were using more conventional health care than women who did not use CAM.

Author Information

From Center for Health Services Research in Primary Care, University of California at Davis, Sacramento, CA; 2Department of Epidemiology and Preventive Medicine and 3Department of Statistics, University of California at Davis, Davis, CA; 4Division of Geriatrics, School of Medicine, University of California at Los Angeles, Los Angeles, CA; 5Department of Epidemiology and Biostatistics, Division of Research, Kaiser Permanente, Oakland, CA; 6Department of Medical Pharmacology and Toxicology, School of Medicine.

Received October 20, 2003; revised and accepted February 24, 2004.

Address correspondence to: Yali Bair, PhD, Assistant Director for State Health Policy Research University of California, Davis Center for Health Services Research, 2103 Stockton Blvd, Suite 2224, Sacramento, CA 95817.

©2005The North American Menopause Society