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Use and discontinued use of menopausal hormone therapy by healthy women in Norway: the Hordaland Women’s Cohort study

Gjelsvik, Bjørn Espen MD1; Straand, Jørund MD, PhD1; Hunskaar, Steinar MD, PhD2; Dalen, Ingvild PhD1; Rosvold, Elin O. MD, PhD1

doi: 10.1097/GME.0b013e3182a11f2d
Original Articles

Objective This work aims to study the use of hormone therapy (HT) in a representative cohort of Norwegian women during the menopausal transition, to identify predictors of HT use, and to describe the reappearance of symptoms in former HT users.

Methods In 1997, 2,229 women in Hordaland County, aged 40 to 44 years, were selected randomly from a national health survey and followed up with seven postal questionnaires in 1999-2010. Data from 2,002 women (90%) were eligible for analysis. Summary statistics and multiple logistic regression analysis were used. We studied the reappearance of symptoms after HT discontinuation using a subcohort based on their propensity scores for HT use.

Results The 2-year incidence of new HT users dropped from 8.2% (95% CI, 7.0-9.5) in 2002 to 4.3% (95% CI, 3.4-5.2) in 2004 and remained stable despite an increasing prevalence of symptoms in the cohort. Self-rated health was stable during the period. The mean duration of HT use was 4.5 years (95% CI, 4.0-5.0). The odds of HT use were higher among women with daily hot flushes than among those who never or rarely experienced them (odds ratio, 3.2; 95% CI, 2.3-4.4). After HT cessation, hot flushes returned and corresponded to those in untreated controls.

Conclusions The 2-year incidence of HT users decreased almost 50% after 2002. Increasing symptoms and decreasing incidence of HT use did not influence self-rated health. Hot flushes were the strongest predictor of HT use. Symptoms reappeared in most women after HT cessation.

From the 1Department of General Practice, Institute for Health and Society, University of Oslo, Oslo, Norway; and 2Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.

Received February 8, 2013; revised and accepted June 17, 2013.

Funding/support: The Hordaland Women’s Cohort is a collaborative project of the Norwegian Health Screening Service (now the Norwegian Institute for Public Health) and the University of Bergen and is partly financed by the Norwegian Research Council. Funding for the present substudy was obtained from the Norwegian Medical Association’s Funds for Research in General Practice and the University of Oslo.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Bjørn Espen Gjelsvik, MD, Department of General Practice, University of Oslo, PO Box 1130, Blindern, Oslo N-0317, Norway. E-mail:

© 2014 by The North American Menopause Society.