Talking the talk: hormone therapy

Posted by Liz on Feb 23, 2009 in health, general, HRT | 2 comments

Is your healthcare provider more or less likely to suggest hormone therapy (HT, estrogen only) when you see them for menopausal symptoms? What’s more, how do you know?

Results of a study in the Ahead of Print edition of the journal Menopause suggest that certain factors do influence prescriber habits.

Researchers measured how often 249 primary care (i.e. internists and family practitioners) and ob/gyns prescribed HT to their patients (ages 45 to 80) in a given year based on electronic pharmacy data. In addition to examining information on the providers themselves, data on perceptions of patients’ views on the Women’s Health Initiative trial results (WHI, which examined the link between HRT and heart disease), provider views on the WHI study and how prepared they felt to counsel patients were also analyzed. 57% of the providers in the study were women.

The findings? How often HT was prescribed appeared to vary by geographical location and the number of years a provider had been at a specific organization (which may reflect the age of the provider). More than half of those surveyed believed that they had expert knowledge about data coming out of recent HT trials.

In fact, primary care providers who felt that they had this degree of knowledge were significantly more likelier than their colleagues who did not to recommend hormone therapy.  In contrast, ob/gyns who were more likely to prescibe HT were those who believed that they well prepared to counsel their female patients on hormone therapy. These practitioners also tended to believe that the results of the trials had been exaggerated.

Regardless of specialty,  younger patients and patients who did not have other diseases that may exacerbate risk were most often prescribed HT.

So, what do these study results mean exactly?

The researchers write that HT prescribing may be “driven by factors outside of evidence-based medicine,” such as prescriber self-perception and age. If this is true, then the lack of provider bias could potentially influence prescribing habits and in turn, exposure to HT.

As the researchers say, “women, who when inquiring about HT risk and benefits, deserve unbiased and well informed counseling to make informed decisions.” And that it “is likely that some doctors need additional training to ensure this level of advice.”

For you, this means to be sure to be prepared when you make that first appointment to discuss therapeutic options for troublesome menopausal symptoms. Do the homework before you enter your provider’s office so that you are ready to ask the right questions.

In addition to the link provided above, which discusses the WHI data in detail, I encourage you to visit the following sites for unbiased information about menopause and its treatment:

Women to Women

Dr. Christiane Northrup, M.D.

Health E Woman

Consumer Reports Health.Org

The bottom line is that if your provider is talking the talk, be sure that you know why you’re going to walk the walk.