Publications
Department of Medicine faculty members published more than 3,600 peer-reviewed articles in 2024.
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OBJECTIVE
To describe the experiences of postmenopausal women who try to stop hormone therapy and to identify characteristics associated with inability to stop.
METHODS
We conducted telephone interviews with 377 randomly selected female members of the Kaiser Foundation Health Plan, aged 50-69 years, who regularly used hormone therapy for at least 1 year before July 1, 2002 and had attempted to stop between July 2002 and March 2003.
RESULTS
Of the 377 women, 280 (74%) successfully stopped and 97 (26%) resumed taking hormone therapy. The major predictor of resuming hormone therapy use was the development of troublesome withdrawal symptoms (odds ratio 8.8; 95% confidence interval 4.9, 16.0). Report of hysterectomy, hormone therapy prescribed by a nongynecologist, and perception of high risk of hip or spine fracture were independently associated with a higher likelihood of unsuccessful stopping. Women with a hysterectomy who had used hormone therapy for 10 or more years and who started hormone therapy mainly for reasons other than health promotion were more likely (P <.001) to be unsuccessful in quitting (44%) compared with those with one or two (25%) or none (9%) of these three characteristics. Most successful stoppers (71%) stopped hormone therapy abruptly, but 29% tapered off hormone therapy; there was no difference in the incidence of troublesome withdrawal symptoms or successful quitting between these two groups.
CONCLUSION
Approximately one quarter of women who try to stop report that they are unable to discontinue postmenopausal hormone therapy, primarily because they develop troublesome withdrawal symptoms. Effective approaches to reducing hormone therapy withdrawal symptoms should be a priority for future research.
View on PubMed2003
OBJECTIVE
To examine whether women who were using postmenopausal hormone therapy (HT) before publication of Women's Health Initiative findings about risks associated with HT had been informed about the findings once published; and to estimate how knowledge of these findings was associated with their decision to discontinue HT.
METHODS
We performed a telephone survey of 670 female members of a large health maintenance organization, aged 50-69 yr, who had regularly used HT from July 1, 2001, through June 30, 2002.
RESULTS
Most women (93%) reported hearing about the new findings; however, only 57% considered the quality of this information to be good, regardless of its source: mass media (21%), the health plan (32%), or a health care practitioner (34%). Women's knowledge of Women's Health Initiative findings was generally poor; 64% did not know what the findings were, 7% were unsure of their knowledge, 6% had incorrect knowledge, and 23% had correct knowledge of Women's Health Initiative findings. On a simple, five-question, true-or-false quiz about HT risks, 30% of respondents answered four to five questions correctly. Although not well informed, 56% reported attempting to discontinue HT in the 6 to 8 months after July 2002. Our multivariable model included five statistically significant predictors of attempting to stop HT: having been sent a letter about Women's Health Initiative findings (odds ratio [OR] 2.7; 95% confidence interval [CI] 1.8, 3.9), reporting good-quality information from media (OR 2.1; 95% CI 1.3, 3.3), having started HT for health promotion (OR 2.0; 95% CI 1.2, 3.3), using a lower-than-standard dosage of estrogen (OR 1.9; 95% CI 1.1, 3.1), and correctly answering four or more items on the HT quiz (OR 1.9; 95% CI 1.2, 2.8).
CONCLUSION
During the 6-8 months after publication of Women's Health Initiative trial findings, most regular postmenopausal HT users tried to stop using HT, despite not being well informed about the Women's Health Initiative findings.
View on PubMed2003
2003
2003