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Clinical and personal relationships between oral contraceptive and hormone replacement therapy use among US women physicians

Frank, Erica MD, MPH1; Elon, Lisa MS, MPH2


Objective To examine relationships between a history of oral contraceptive (OC) use and current use of or intention to use hormone replacement therapy (HRT).

Design The Women Physicians' Health Study examined a stratified random sample of US women MDs, aged 30 to 70 years (4,501 respondents; a 59% response rate).

Results Among postmenopausal physicians who previously used OCs, current HRT use was significantly associated (P < 0.05) with being younger, living somewhere besides the East Coast, being sexually active, being an obstetrician/gynecologist, having no history of breast cancer, having a longer use of OCs, and being posthysterectomy. Among premenopausal physicians, intended future HRT use was significantly associated with being white, being an obstetrician/gynecologist, being in good health, living somewhere besides the East Coast, being a longer user of OCs, and having more extensive, recent continuing medical education.

Among women who had taken both OCs and HRT, there were no significantly elevated rates in any of the 15 health conditions we examined (after controlling for family history).

Postmenopausal physicians who took HRT (and premenopausal OC-using physicians intending to take HRT) were significantly more likely to counsel their patients on HRT use. Among post-OC HRT-users, 44% counseled their postmenopausal female patients on HRT at least yearly versus 22% of post-OC HRT-nonusers (74% v 45% among such primary care physicians).

Conclusions Physicians' personal OC/HRT use may strongly affect their patient counseling practices. HRT use after OC use was not associated with any obvious increases in examined diseases in this population.

From the 1Department of Family and Preventive Medicine, Emory University School of Medicine, 2Rollins School of Public Health, Emory University, Atlanta, GA.

Received April 8, 2002; revised and accepted August 15, 2002.

This work was funded by a grant-in-aid agreement from Wyeth.

Address reprint requests to Erica Frank, MD, MPH, Emory University, 69 Butler Street, Atlanta, GA 30303. E-mail:

©2003The North American Menopause Society