Cross-national study of women's use of hormone replacement therapy (HRT) in Europe

The benefits of hormone replacement therapy (HRT) to perimenopausal and postmenopausal women are well established. Women from France, Germany, Spain, and the United Kingdom were interviewed to determine: (1) knowledge and views of menopause and HRT; (2) history of HRT among current and lapsed users; and (3) reasons of non-users for never having taken HRT. In 1996, nearly 1,500 women aged 40 to 65 answered a short series of questions concerning menopause and HRT as part of a consumer omnibus survey; others (n = 929) participated in a focused survey of attitudes toward and use of HRT. Only one-third of perimenopausal and 13% of postmenopausal women currently were taking HRT. About 25% of postmenopausal women reported having taken HRT at some time. The proportion of perimenopausal women using HRT varied by country, and ranged from 18% in Spain to 55% in France. Importantly, about half (range across countries, 38% to 61%) of the women interviewed had not discussed menopause or its symptoms with their doctors. While levels of HRT knowledge varied by country, two-thirds of respondents overall believed they needed more information about HRT. Decisions about beginning HRT and choosing a formulation were viewed by most women as matters of personal choice, to be made with advice from a physician. In summary, despite the benefits of HRT and available choices among drug delivery options, a fairly small proportion of European women use it, largely because most remain poorly informed about the therapy. Increased physician-patient communication and public education programs are needed to provide women with the information they need to make judicious decisions concerning HRT.