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Hormonal contraception and postmenopausal hormone therapy in Spain: time trends and patterns of use
Laura Costas1, Víctor-Guillermo Sequera, Paloma Quesada
11Unit of Infections and Cancer, Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain 2Department of Medicine, University of Barcelona, Barcelona, Spain 3Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiologia y Salud Pública), Madrid, Spain 4Preventive Medicine and Epidemiology Service, Hospital Clínic of Barcelona, Barcelona, Spain 5Public Health Division of Gipuzkoa, San Sebastian, Spain 6Biodonostia Research Institute, San Sebastian, Spain 7Environmental and Cancer Epidemiology Area, National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain 8Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro, Madrid, Spain 9Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, León, Spain 10Universidad de Cantabria-IDIVAL, Santander, Spain 11Public Health Institute of Navarra, Pamplona, Spain 12Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Madrid, Spain 13Institute of Oncology, IUOPA, University of Oviedo, Oviedo, Spain 14Cancer Prevention Program, Catalan Institute of Oncology, IDIBELL, Barcelona, Spain 15Servicio de Medicina Interna, Complejo Hospitalario de Huelva-Hospital Infanta Elena, CYSMA, Huelva, Spain 16Fundación para el Fomento de la Investigación Sanitaria y Biomédica, FISABIO, Breast Cancer Screening Program, Valencian Public Health Directorate, Valencia, Spain 17Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain 18Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario de Granada, Servicio Andaluz de Salud/Universidad de Granada, Granada, Spain 19Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia and Descriptive Epidemiology, Genetics and Cancer Prevention Group (Girona Biomedical Research Institute), Catalan Institute of Oncology, G
Objective:
This study aims to describe time trends in and patterns of use of hormonal contraception and postmenopausal hormone therapy and to identify factors associated with their use among Spanish women.
Methods:
We performed a cross-sectional analysis using data from 1,954 population controls (aged 24-85 y) in 12 provinces of Spain who were enrolled in the Multi Case-Control Spain study (2007-2013). Data were collected from a questionnaire conducted face-to-face by trained personnel. We collected information on sociodemographic factors, lifestyle, sleep patterns, reproductive history, and occupational history.
Results:
Overall, 48.5% of Spanish women reported ever use of hormonal contraception, and 9.8% of women in the postmenopausal group reported use of postmenopausal hormone therapy. Younger cohorts used hormonal contraception for a longer period, whereas postmenopausal hormone therapy use dramatically dropped in the 2000s. Women with higher education levels (including education of partners) and smoking history were the most probable users of hormonal contraception, whereas inverse associations were observed among housewives, obese women, and nulliparous women. Postmenopausal hormone therapy use was associated with a surgical or therapeutic cause of menopause and with occupational history of rotating shifts.
Conclusions:
In this Spanish population, several demographic, lifestyle, occupational, and reproductive factors are associated with use of hormonal compounds. Characterizing hormonal users and monitoring trends in the use of these hormonal compounds are essential from a public health perspective.
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