Multiple physician clusters and the...

Multiple physician clusters and the U.S. Preventive Services Task Force commend that physicians counsel postmenopausal patients about the individual risks and benefits of using hormone therapy. generally information about the risks and benefits of hormone therapy is incomplete. In addition, no existing studies assess the attitudes, perceptions, and motivations of women faced with the choice of using hormone therapy. Women usually start hormone therapy to relieve menopausal symptoms. They continue or discontinue hormone therapy based in succession concerns about breast cancer, uterine and endometrial cancer, menstrual bleeding, and other side purports Few nonusers understand that they have an increased risk of developing osteoporosis based upon their estrogen deficiency. Scheid and colleagues examined the relationship between the use of hormone therapy and women's perceptions of the risks and benefits.

Women who participated in a screening program for bone mineral density by means of 64 centers made up the sample population. Women who agreed to participate were asked to completed a questionnaire that included information forward demographics, clinical characteristics, body orientation, health, menopausal symptoms and attitudes about these symptoms, and use of prescribed or nonprescribed treatments for menopause symptoms or osteoporosis prevention. The participants were asked to estimate their lifetime probability of developing breast cancer, uterine cancer, or osteoporosis. They also were asked the same question concerning lifetime probability of myocardial infarction when taking or not taking hormone therapy. The questionnaire had a final section that argueed information on the women's quality of life at their in every one's mouth health status and what it would be if they disentangleed breast cancer, uterine cancer, osteoporosis, or myocardial infarction.

The attitudes of women who used or did not use hormone therapy did not differ with regard to preventing menopausal symptoms, general health, carcass orientation, and locus of have the direction of Women who were using hormone therapy perceived a greater reduction in the risk of developing osteoporosis and myocardial infarction than women who did not use hormone therapy. the couple groups estimated their lifetime probability of developing breast cancer, uterine cancer, osteoporosis, and myocardial infarction at inflated on a levels when compared with established probabilities. Women who did not use hormone therapy perceived a greater increase in the risk of developing breast or uterine cancer if they started hormone therapy, compared with the perceived risk among women who were already using hormone therapy. Women who used hormone therapy believed that they had a lower risk of developing osteoporosis and myocardial infarction because they were using hormone therapy. Quality-of-life measurements were similar in one as well as the other groups except in regard to osteoporosis.

The authors decide that women overestimate the risk of the four diseases studied regardless of their passing from hand to hand hormone therapy status. Women who use hormone therapy believe these medications transfer a greater reduction in risks for osteoporosis and myocardial infarction, with a smaller increase in the risk of developing breast and uterine cancers. Continuing efforts to assist women in understanding the risks and benefits of hormone therapy would be helpful.

Scheid DC et al. Do perceptions of risk and quality of life affect use of hormone replacement therapy according to postmenopausal women? J Am Board Fam Pract July-August 2003;16:270-7

EDITOR'S NOTE: Physicians should be aware of their patients' understanding of the risks and benefits of hormone therapy during menopause. Along with studies questioning an previous assumptions about this therapy, patients are looking to their physicians for balanced information. The thought by Scheid and colleagues demonstrates that, despite a great deal information in the lay pres patients still lack an understanding of the risks and benefits of hormone therapy and wait on to overestimate both. When discussing hormone therapy with patients, physicians should provide balanced information and obtain informed co-operation if patients choose to initiate this therapy.--K.E.M.

COPYRIGHT 2004 American Academy of Family Physicians

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