Compliance with hormone replacement therapy after prophylactic oophorectomy

Abstract

O varian cancer remains one of the comm onest causes of death in women within the 40± 70 year age group and it is known that bilateral oophorectomy is still the only available method of prevention of ovarian cancer. This practice should be reviewed if the rate of compliance with H orm one replacem ent therapy (HRT ) after a bilateral oophorectomy is as poor as it is suggested in the general population.Hormone replacem ent therapy alleviates vasomotor s ym ptom s and protec ts ag ainst osteoporosis and cardiovascular disease. There is also recent evidence that it may delay the onset of and decrease the risk of A lzheim er's disease (Tang et al., 1996).A ll pat ie nts at B ene nd en H o spital w ho had undergone bilateral oophorectomy and hysterectomy from January 1993 to August 1995 (and so had a m inimum of 2 years follow up) were identi® ed. Exclusion criteria included, wom en aged over 65 at the time of hysterectomy, wom en having a hysterectomy for m alignan t disease, the presence of severe endometriosis and all with a contraindication to hormone replacement therapy. The women were than contacted, to assess their use of hormone replacement. ResultsO ut of 266 patients identi® ed, 207 patients replied. The m edian age of the patients who responded was 50 years, with a range of 35 to 65 years. One hundred and ninety (91´8% ) of the women were taking HRT at the time of the survey and of these 68 (35´7% ) had changed preparations at som e time.Thirty-six (17´4% ) patients were already taking HRT before hysterectomy. The m ajority (65´6% ) used oral H RT. On discharge from hospital, 20 (9´7% ) patients were prescribed oral oestrogens, 126 (60´7% ) patients received oestrogen patches and 61 (29´6% ) patients had oestradiol implants inserted.