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Trends in oral and vaginally administered estrogen use among US women 50 years of age or older with commercial health insurance

Weissfeld, Joel L. MD, MPH1; Liu, Wei PhD1; Woods, Corinne RPh, MPH1; Zhang, Rongmei PhD2; Li, Jie PhD, MBBS1; van der Vlugt, Theresa H. MD, MPH3; Slaughter, Shelley R. MD, PhD3

doi: 10.1097/GME.0000000000001054
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Objective: We aimed to provide information through 2015 about use in the United States of estrogen products, including orally and vaginally administered products, in postmenopausal women.

Methods: We used prescription claims for US commercial health insurance to calculate, in women 50 years of age or older (n = 12,007,364), the age-standardized and age-specific annual prevalence of estrogen use, by formulation and route of administration, for the period 2006 through 2015.

Results: The age-standardized annual prevalence of a prescription claim for oral estrogens declined over time, from 83 per 1,000 women in 2007 to 42 per 1,000 women in 2015. The age-standardized annual prevalence of a prescription claim for vaginal estrogens peaked in 2011, at 42 per 1,000 women, before declining to 35 per 1,000 women in 2015. The age-standardized annual prevalence of a prescription claim for transdermal estrogen fluctuated between 15 and 17 per 1,000 women. In age groups under 65 years of age, annual prevalence rates for vaginal rings and inserts declined over the latter half of the study period.

Conclusions: Analyses of US prescription claims data between 2006 and 2015 for women 50 years of age or older showed declining use of oral estrogen generally and vaginally administered estrogen products specifically in age groups less than 65 years of age.

1Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD

2Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD

3Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD.

Address correspondence to: Joel L. Weissfeld, MD, MPH, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993. E-mail: Joel.Weissfeld@fda.hhs.gov

Received 17 October, 2017

Revised 21 November, 2017

Accepted 21 November, 2017

Disclaimer: This article reflects the views of the authors and should not be construed to represent FDA's views or policies.

Funding/support: The authors completed this work using resources available to the Food and Drug Administration.

Financial disclosure/conflicts of interest: None reported.

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© 2018 by The North American Menopause Society.