A third of all menopausal and post-menopausal women are undecided about hormone replacement therapy (HRT), according to new research. They may not be getting the information they need to make informed decisions that weigh the risks and benefits involved.
"When it comes to considering the balance of risks and benefits for individual women, one size does not fit all," says Andrea Z. LaCroix, PhD, Group Health Cooperative of Puget Sound, a large HMO headquartered in Seattle. "These decisions are highly complex because women's risk levels, values and preferences differ and because the scientific evidence of benefits and risks continues to evolve," said LaCroix, lead researcher in a study on information and decision making in menopausal women.
The Department of Health and Human Services' Healthy People 2000 has set a goal that 90 percent of perimenopausal women receive HRT counseling for osteoporosis prevention by the Year 2000. Studies have shown that HRT reduces the risk of osteoporosis and heart disease, but no definitive trials have been published. HRT also may lower the risk of Alzheimer's disease and colon cancer. However, it can increase the risk of uterine cancer and thrombosis, but its relation to breast cancer risk remains uncertain.
"Not much was known about the large group of menopausal women -- a full third -- who are undecided about use of HRT," according to Lori Bastian, MD, MPH, Durham Veterans Affairs Medical Center in North Carolina. Bastian is lead author of a study that investigated the attitudes and knowledge base of undecided menopausal women as a first step toward designing interventions to reach this group.
Identifying women who have not made a decision about HRT may help in designing interventions that lead to better personal decisions and greater satisfaction for this group, Bastian and her colleagues believe.
Both studies appear in the December issue of Women's Health Issues.