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Health characteristics of women beginning postmenopausal hormone therapy: have they changed since the publication of the Women’s Health Initiative?

Fournier, Agnès PhD1,2; Fritel, Xavier MD, PhD2,3,4; Panjo, Henri MSc2,3,5; Zins, Marie MD, PhD6,7; Ringa, Virginie MD, PhD2,3,5

doi: 10.1097/GME.0000000000000159
Original Articles
Editorial

Objective: After we demonstrated a substantial drop in postmenopausal hormone therapy (HT) in France after 2002, we sought to compare health characteristics assessed before menopause and reasons for beginning treatment among women who started postmenopausal HT before and after this year.

Methods: Among participants of the GAZEL (GAZ and ELectricité) cohort of employees of the French national power company, we studied 1,229 women who reached menopause before 2002 and 562 women who reached menopause after 2002. We analyzed HT use among these newly postmenopausal women before and after 2002 and its relations to self-rated health, simple and troublesome hot flushes, and various other symptoms before menopause.

Results: After 2002, compared with before 2002, women starting HT were more likely to have reported troublesome hot flushes before menopause (odds ratio, 2.3; 95% CI, 1.0-5.4). The groups of new HT users did not differ significantly except for health characteristics. Significantly higher proportions of women starting HT reported using it for hot flushes (68.1% vs 52.9%, P = 0.02) and sleep disorders (11.1% vs 2.8%, P = 0.001) and a significantly lower proportion of women starting HT reported using it for osteoporosis prevention (12.5% vs 43.9%, P < 0.001) after 2002 than before 2002.

Conclusions: After 2002, HT tended to be prescribed for more severe hot flushes, but almost one third of prescriptions were still written for reasons not linked to hot flushes. Doctors seem to be following recommendations to not use HT as a first-line treatment of osteoporosis.

From the 1Nutrition, Hormones, and Women’s Health Team, INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France; 2UMRS 1018, Univ Paris Sud, le Kremlin Bicêtre, France; 3Gender, Sexual and Reproductive Health Team, INSERM U1018, Center for Research in Epidemiology and Population Health, le Kremlin Bicêtre, France; 4Service de Gynécologie-Obstétrique et Médecine de la Reproduction, INSERM CIC802, CHU de Poitiers, Université de Poitiers, Poitiers, France; 5INED, Paris, France; 6Population-Based Cohorts Research Platform, INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France; and 7UMRS 1018, Université Versailles-Saint-Quentin, Villejuif, France.

Received August 12, 2013; revised and accepted October 18, 2013.

Funding/support: The GAZEL (GAZ and ELectricité) cohort study was funded by Electricité de France-Gaz de France and Institut National de la Santé et de la Recherche Médicale, and received grants from the Cohortes Santé TGIR Program, Agence Nationale de la Recherche, and Agence française de sécurité sanitaire de l’environnement et du travail. Agence Nationale de Sécurité du Médicament et des Produits de Santé allocated specific funding for this particular study.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Virginie Ringa, MD, PhD, INSERM U1018, Center for Research in Epidemiology and Population Health, Equipe 7, hôpital de Bicêtre, 82 rue du Gal Leclerc, le Kremlin Bicêtre 94276, France. E-mail: Virginie.ringa@inserm.fr

© 2014 by The North American Menopause Society.