Sources of information and HRT prescribing practices among gynecologists in Puebla, Mexico

The purpose of this study was to determine the sources of information and hormone replacement therapy (HRT) prescribing practices of gynecologists in the capital city of Puebla, Mexico.

Practicing gynecologists (n=44) in 29 colonias (neighborhoods) in the city of Puebla completed a self-administered standardized questionnaire. Survey topics included primary sources of information about HRT, discussion of patient health practices, awareness of alternative medicines, and HRT prescribing practices.

Medical journals, hospital presentations, and textbook manuals were rated as the primary sources of information about HRT by 69-73% of physicians. Patients were rated as a primary source of information by 25% of physicians, and pharmaceutical representatives by 16% of physicians. Almost all physicians reported a willingness to discuss diet, smoking habits and other health issues with their patients. Natural and herbal medications were recommended by 25% of physicians. Contrary to studies in the US, more male than female physicians reported recommending hormones to 90-100% of their menopausal patients (60 vs. 33%, n.s.).

This study revealed that physicians utilize a wide range of information about HRT, including patients and pharmaceutical representatives. Physicians' willingness to list patients as a source of information about HRT indicates the degree to which patients are involved in the medicalization of menopause. Reasons given for prescribing HRT (e.g. prevention of osteoporosis) were similar to those identified in studies in the US and Canada. Some variation in physician attitudes and practices related to HRT was apparent within the city of Puebla, Mexico.