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Related Experiment Videos

Selection to postmenopausal therapy by women's characteristics

E Hemminki1, M Malin, P Topo

  • 1Department of Public Health, University of Helsinki, Finland.

Journal of Clinical Epidemiology
|March 1, 1993
PubMed
Summary

Current hormone therapy users, particularly older women, exhibit better health indicators than non-users. This suggests self-selection bias may influence observational studies on hormone therapy and health outcomes.

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Area of Science:

  • Reproductive Health
  • Epidemiology
  • Gerontology

Background:

  • Observational studies suggest postmenopausal hormone therapy (HT) is associated with reduced cardiovascular disease and mortality.
  • However, potential confounding factors, including health-seeking behaviors of users, require investigation.

Purpose of the Study:

  • To compare health indicators between current, past, and non-users of HT in middle-aged and older Finnish women.
  • To assess if women selecting HT possess better health prognoses, potentially biasing observational findings.

Main Methods:

  • A 1989 survey of 2000 randomly selected Finnish women aged 45-64 with an 86% response rate.
  • Analysis compared health indicators between HT user groups (current, past, non-users), adjusting for age and urbanism.

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Main Results:

  • Among women with uteri, non-users showed poorer health prognoses across 10 of 21 indicators compared to current users.
  • Differences were more pronounced in older women, suggesting cohort effects or selection of long-term users.
  • Past users' health profiles resembled non-users more than current users.

Conclusions:

  • Findings suggest that women with better health prognoses are selected for, or self-select into, HT use.
  • This self-selection bias may confound interpretation of observational studies linking HT to health outcomes.
  • Further research is needed to disentangle the effects of HT from user characteristics.