Why do postmenopausal women discontinue hormone replacement therapy?

Vihtamäki, Tarja; Savilahti, Risto; Tuimala, Risto

doi:10.1016/s0378-5122(99)00047-x

Cited by 61 publications

(31 citation statements)

References 20 publications

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“…Levens and Williams found that women overestimated the risks of HRT, although 77% of users had overall positive attitudes towards HRT [12]. Adverse reactions and fear of cancer are the most common reasons for stopping using HRT [20,21].…”

Section: Discussionmentioning

confidence: 99%

Do Finnish women using hormone replacement therapy need more information about risks

2007

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Section: Discussionmentioning

confidence: 99%

Do Finnish women using hormone replacement therapy need more information about risks

2007

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“…This is especially relevant because it has been suggested that compliance may be worse for preventative regimens than for short term medication. The effects of HRT in reducing the risk of postmenopausal osteoporosis appear to be dependent on the duration of treatment 1,32,33 and administration for at least five years is required to achieve this goal 34 . For these reasons, it seems plausible to assume a direct correlation of a drug's efficacy with the degree of its long term acceptance by the patient.…”

Section: Discussionmentioning

confidence: 99%

“…This may reflect the increased occurrence of adverse events-specifically breast pain and bleeding-in this group. The main reasons for discontinuing HRT in previous studies have been non-acceptance of bleeding, fear of cancer and negative side effects 34 . These findings are of note because one of the reasons for the development of ccHRT was to improve upon prior issues identified with sequential HRT such as bleeding.…”

Section: Discussionmentioning

confidence: 99%

A randomised, double-blind trial comparing raloxifene HCl and continuous combined hormone replacement therapy in postmenopausal women: effects on compliance and quality of life

Voss¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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A list of the Euralox Investigators Group may be found on pages 882 -883Objective To compare continuous combined hormone replacement therapy (ccHRT) and raloxifene with respect to compliance and quality of life, which were predefined secondary endpoints of a large, prospective study designed to investigate the uterine effects of both treatments. Design Double-blind, randomised controlled trial of six-month duration. Setting One hundred and twenty-nine gynaecology hospital departments, clinics or practices specialised in women's healthcare, located in Europe, South Africa and Israel. Population Healthy postmenopausal women (n ¼ 1008). Main outcome measures Changes in quality of life using the Women's Health Questionnaire (WHQ) and compliance using a compliance questionnaire and pill count. Adverse event and early discontinuation rates and satisfaction with treatment using a visual analogue scale (VAS). Results Women taking raloxifene reported greater satisfaction with their treatment as assessed on the VAS ( P ¼ 0.004),and a lower proportion, as compared with ccHRT, reported being worried by the treatment (9.6% vs 20.2%, P < 0.01). Women taking ccHRT reported greater deterioration in scores from the WHQ for depressed mood and menstrual symptoms than those taking raloxifene ( P < 0.01). For memory, vasomotor symptoms and sexual behaviour, the ccHRT group reported significantly greater mean improvements ( P < 0.05). Over half (58.8%) of those taking raloxifene noticed no effect, 37.7% felt better and 3.4% felt worse as measured using the compliance questionnaire. Fifty percent of the women taking ccHRT felt better, 37.8% noticed no effect but over 10% felt worse. More women on raloxifene (94.6%) than on ccHRT (85.9%) reported that they were taking their double-blinded medication regularly ( P < 0.01). Conclusions A lower rate of adverse event-related discontinuations, the lack of negative effects on quality of life and a smaller proportion of women being worried by the drug treatment were associated with higher treatment satisfaction and better compliance in postmenopausal women taking ccHRT or raloxifene.

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“…HRT relieves climacteric symptoms and is generally believed to protect against diseases typical of the elderly population such as osteoporosis (for review, see (18 -22)). Unfortunately, many women discontinue the use of HRT after a couple of years, mainly because of fear of cancer and advice by physicians (23). There is no consensus, at present, whether serum E 2 levels should be followed during ERT; however, it has been pointed out by us and other authors that the relief of climacteric symptoms does not necessarily guarantee protection against osteoporosis and other diseases of elderly women believed to be related to the deficiency of E 2 (6,7,24).…”

Section: Discussionmentioning

confidence: 99%

Self-adjusted postmenopausal hormone replacement therapy: effects on the biological and immunological profile of FSH and correlation to climacteric symptoms

Vihtamäki

Simoni²,

Tuimala³

et al. 2002

European Journal of Endocrinology

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Objective: The purpose of the present study was to evaluate the hormonal profile of patients of postmenopausal age during estrogen replacement therapy (ERT) with special reference to the serum levels of biologically active FSH (B-FSH) in a self-adjusted ERT model. Design:The hormonal values found have been correlated to climateric symptoms reported by the patients (scored by the Kupperman menopausal index (KI)). Methods: B-FSH was measured using an assay based on a cell system transfected permanently with FSH receptor cDNA. All women ðn ¼ 32Þ applied estradiol percutaneously using 1 mg estradiol17b (E 2 ) as an initial dose and were encouraged to increase the daily dose until they felt comfortable according to a specific scheme. Twelve of the 32 women were hysterectomized and treated, accordingly, with ERT only; 20 women received megestrol acetate monthly for 10 days. Results: The initial average KI was 30 (range 10-54). A high degree of correlation ðr ¼ 0:83; P , 0:001Þ was observed between B-FSH and immunologically active FSH (I-FSH). Serum I-FSH and E 2 correlated negatively ðr ¼ 20:21; P , 0:001Þ; similarly, a negative correlation ðr ¼ 20:15; P , 0:01Þ was observed between serum B-FSH and E 2 levels. Serum I-FSH and KI showed modest but significant positive correlation ðr ¼ 0:13; P , 0:01Þ; a somewhat higher degree of correlation ðr ¼ 0:19; P , 0:005Þ was observed when B-FSH and KI were compared. E 2 showed positive correlation to serum sex-hormone binding globulin levels ðr ¼ 0:22; P , 0:001Þ: Conclusions: This study shows that the transdermal self-adjusted hormone replacement therapy (HRT) model introduced is suitable for studies on endocrine changes during postmenopausal ERT. The finding of poor correlation between serum E 2 levels and KI emphasizes the importance of hormonal measurements during postmenopausal HRT.

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Why do postmenopausal women discontinue hormone replacement therapy?

Cited by 61 publications

References 20 publications

Do Finnish women using hormone replacement therapy need more information about risks

Do Finnish women using hormone replacement therapy need more information about risks

A randomised, double-blind trial comparing raloxifene HCl and continuous combined hormone replacement therapy in postmenopausal women: effects on compliance and quality of life

Self-adjusted postmenopausal hormone replacement therapy: effects on the biological and immunological profile of FSH and correlation to climacteric symptoms

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