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Menopausal Hormone Tx Use Down Post-WHI Recommendations

But large declines seen in subgroups for whom MHT is recommended, including younger women

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MONDAY, Jan. 14, 2019 (Pharmacist's Briefing) -- The Women's Health Initiative (WHI) recommendations for menopausal hormone therapy (MHT) use issued in 2002 have been widely adopted, according to a study published online Dec. 21 in Menopause.

Sybil L. Crawford, Ph.D., from the University of Massachusetts Medical School in Worcester, and colleagues analyzed survey data from 3,018 participants in the Study of Women's Health Across the Nation. Participants each had up to 14 approximately annual visits from 1996 to 2013. The authors examined pre-WHI versus post-WHI differences in HRT initiation and continuation and their correlates.

The researchers observed a decrease in MHT initiation from 8.6 to 2.8 percent pre-WHI to post-WHI; the corresponding decrease in MHT continuation was 84.0 to 62.0 percent. Consistent with wide dissemination of post-WHI recommendations, the decreases in MHT initiation and continuation were seen across a range of participant subgroups. However, large declines in MHT use were seen in subgroups for whom MHT is often recommended, including younger women and those with more vasomotor symptoms, contrary to current guidelines. After the WHI July 2002 announcement, reasons for MHT initiation and discontinuation reflected concerns highlighted by WHI results.

"The results of this analysis support the need for more education about personalized risk/benefit profiles for women and providers as MHT research translates to public health recommendations, to ensure evidence-based care of women through menopause and beyond," the authors write.

One author disclosed financial ties to Merck, Pfizer, KaNDy, and Sojournix.

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