Trends of Postmenopausal Estrogen Plus Progestin Prevalence in the United States Between 1970 and 2010

Abstract

Objective To estimate long term trends in estrogen–progestin prevalence for the U.S. female population by year and age. Methods We integrated data on oral estrogen–progestin use from NHANES 1999–2010 with data from the National Prescription Audit 1970–2003. Distributions of estrogen–progestin by age from NHANES were applied to the prescription data, and calibration and interpolation procedures were used to generate estrogen–progestin prevalence estimates by single year of age and single calendar year for 1970–2010. Results Estimated prevalence of oral estrogen–progestin was below 0.5% in the 1970s, began to rise in the early 1980s, and almost tripled between 1990 and the late 1990s. The age-adjusted prevalence for women aged 45–64 peaked at 13.5% in 1999, with highest use among 57 year-old women (23.2%). Prevalence of estrogen–progestin use declined dramatically in the early 2000s, with only 2.7% of women aged 45–64 using estrogen–progestin in 2010, which is comparable to prevalence levels in the mid-1980s. Conclusion The dramatic rise and fall of estrogen–progestin use over the past 40 years provides an illuminating case study of prescription practices before, during, and after the development of evidence regarding benefits and harms.

Management of Menopausal Symptoms

“…Although use of systemic HT has dramatically declined since initial 2002 publication of findings from the Women’s Health Initiative, 70 some three quarters of U.S. women aged 57–74 years are sexually active. 71 These observations underscore the importance of recognizing and treating genitourinary syndrome of menopause.…”

Terapia hormonal de la menopausia, ¿por qué prescribirla?

“…El climaterio se asocia al incremento de enfermedades crónicas como osteoporosis y enfermedad cardiovascular (1)(2)(3) y deterioro de la calidad de vida. La terapia hormonal de la menopausia (THM) y los cambios en el estilo de vida saludables constituyen las principales armas terapéu-ticas para contrarrestar los efectos de la menopausia en la salud de la mujer (1) .…”

“…La terapia hormonal de la menopausia (THM) y los cambios en el estilo de vida saludables constituyen las principales armas terapéu-ticas para contrarrestar los efectos de la menopausia en la salud de la mujer (1) . Sin embargo, la THM, después de haber alcanzado una gran popularidad entre los médicos y las mujeres hace algunas décadas fue abandonada masivamente a partir del año 2002 como consecuencia de la publicación del estudio de Iniciativa de Salud de la Mujer (WHI), que señaló que los riesgos de esta terapia superaban a los beneficios (2,3) . En este artículo analizaremos el impacto que puede provocar en la salud de la mujer la no prescripción de THM.…”

Does the menopausal status of female gynecologists affect their prescription of menopausal hormone therapy?

“…Menopausal hormone therapy (MHT) is an important therapeutic weapon used to counteract the consequences of this deficit, improving quality of life 4 and also decreasing the risk of chronic diseases 5 and probably mortality 6 . However, after the publication of the results of the Women's Health Initiative (WHI) study showing that, in relation to chronic disease, MHT was associated with more risks than benefits 7 , its use has declined severely among postmenopausal women 8 . Although different authors have stated that the results of the WHI study have selection bias 9 , and that methodological errors distort results 10 , MHT use has never returned to rates reported prior to the publication of this study.…”