Weighing the cons and pros: women's reasons for discontinuing hormone replacement therapy

As a greater proportion of U.S. women move into midlife, there has been increased interest in meeting their preventive health needs. Although hormone replacement therapy (HRT) may not be an option for all postmenopausal women, it has been documented as prolonging life expectancy and protecting against osteoporosis. Despite its advantages for many women, often those who initiate HRT discontinue its use within a short time. The purpose of this qualitative study is to gain insights into women's reasons for discontinuing HRT. We collected data by semistructured interview from three diverse samples: 10 women who had been on HRT for two years or less, 11 health care providers of women, and 34 women who had gone off HRT. Reasons for discontinuing fell into seven broad categories: general Gestalt, somatic complaints, mind (knowledge, emotion), not being heard, hassles, indecisive medical community, and cons outweighed pros. Results indicate that women who discontinue HRT do so for a variety of reasons, many of which are connected to the health care system and its providers. Outcomes also suggest that sharing in decision making along with increased education, support, and individualized care are necessary to better address the preventive health care needs of postmenopausal women.