Prevalence and causes of persistent use of hormone replacement therapy among postmenopausal women: a follow-up study

In a previous study analyzing data from September 2002 to February 2003, we showed that, despite the Women's Health Initiative trial results, many women still remained on hormone replacement therapy (HRT) in an internal medicine practice. However, it is not known whether such use has persisted over time. We performed a retrospective chart analysis of 1000 postmenopausal women seen at the same internal medicine practice from January 2004 to May 2004 to establish whether the prevalence of HRT use had declined, remained stable, or increased when compared with our previous data and to determine the reasons for continued HRT use. Among 1000 postmenopausal women, mean age 66+/-9 years, 116 (12%) remained on HRT (HRT users) in 2004. The prevalence of HRT users declined from 16% to 12% (P<0.01) over a period of 15 months. Among HRT users, the main reasons for continued use were severe menopausal symptoms in 39 (34%), patient preference in 17 (15%), osteoporosis or osteopenia in 14 (12%), failed attempt at discontinuation in 13 (11%), taper in progress in 12 (10%), gynecologist recommendation in 10 (9%), not documented in 8 (7%), and other reasons in 3 (3%). The use of HRT declined over time in an internal medicine clinic since the publication of the Women's Health Initiative study. However, 12% of the women still remained on HRT in 2004. The severity of menopausal symptoms, patient preference, and osteoporosis or osteopenia played a prominent role in the decision to remain on HRT.