Premenopausal determinants of menopausal estrogen use

Characteristics related to subsequent use of estrogen replacement therapy were evaluated prospectively in a cohort of 541 healthy premenopausal women being followed through the menopausal transition.

Among women who became menopausal during the follow-up period, the most striking premenopausal baseline differences between menopausal estrogen users and never users were that users tended to be thinner and more likely to report past oral contraceptive use than never users (P less than or equal to 0.05). Nonsignificant trends were also observed, with menopausal estrogen users having higher total high-density lipoprotein cholesterol and lower fasting insulin prior to estrogen use than the menopausal never users (P less than or equal to 0.10). Weaker trends included greater alcohol intake and past week kilocalorie expenditure and lower blood pressure levels among menopausal estrogen users than never users.

Although these findings do not preclude the probable protective effect of estrogen therapy on coronary heart disease morbidity and mortality, they do suggest that slightly healthier women may take menopausal hormones.