Changes in women's attitudes towards and use of hormone therapy after HERS and WHI

To assess changes in women's attitudes towards risk and benefits of, and use of hormone treatment in the menopausal transition (HT) before and after Heart and Estrogen/Progestin Replacement Study (HERS) and the oestrogen and progestin trial of Women's Health Initiative (WHI).

Postal questionnaires to all women 53 and 54 years of age in a Swedish community in 1999 (n=1.760) and 2003 (n=1.733). Data on sales of HT were collected from the database of the National Corporation of Swedish Pharmacies.

The fraction of women reporting current use of HT fell from 40.5 to 25.3% (p<0.001, chi2-test) both by fewer women starting and more women discontinuing treatment. This corresponded to a decrease in dispensation of HT in Linköping and nationwide for the same age group. The fraction of women who had tried complementary treatment for climacteric discomfort, increased from 9.6 to 18.1% for natural remedies (p<0.001, chi2-test). Women perceived HT as more risky and less beneficial in 2003 as compared with 1999 (both p<0.001, chi2-test). The most frequent source of information about HT during the last year before the 2003 questionnaire were newspaper or magazines (43.8%) and television or radio (31.7%).

The decreased use of HT in the community correlated with pronounced changes in the attitudes towards HT. Media were a more frequent source of information than health care personnel. This indicates that media reports about major clinical studies might have influenced the use of HT among women.