Female physicians more
likely to use hormone therapy
Woman doctors who have undergone menopause use hormone replacement therapy
(HRT) at nearly twice the rate of other postmenopausal women, according
to an Emory published recently in Annals of Internal Medicine. The study
is the first to evaluate woman physicians' use of HRT.
The study found 47 percent of 1,466 postmenopausal women doctors were
using HRT when surveyed in 1993-94. Though prevalence rates of HRT vary
among postmenopausal women in the general population-from eight percent
in Massachusetts to more than 40 percent in Western states-the national
rate has previously been estimated at 24 percent.
"Woman doctors are more likely to use HRT perhaps because they are
most likely to be aware of the benefits and risks of HRT," said lead
author Sally McNagny, an assistant professor in the School of Medicine.
"In patient surveys, [non-physician] patients who are better educated,
wealthier and live in the Pacific states are also more likely to use HRT,
whereas women with a low income, in a minority group and less educated are
Usage rates were highest among physicians soon after menopause. The researchers
reported that 60 percent of subjects aged 40-49 used HRT, compared with
49 percent of subjects aged 50-59 and 36 percent of subjects aged 60-70.
The postmenopausal physicians who reported using HRT were more likely
than their peers to be gynecologists (three times more likely to use HRT),
younger, Caucasian and sexually active (twice as likely).
Physician HRT users were twice as likely to have used oral contraceptives
in the past and more likely inhabitants of the Pacific and Mountain states
(doctors in the North Atlantic states had the lowest rates), to have had
a hysterectomy and to have no personal or family history of breast cancer.
Even though many scientists believe HRT may protect against heart disease,
women doctors with risk factors for heart disease, such as being a smoker,
having diabetes or having a family history of heart disease, were not more
likely to choose HRT.
Data came from the Women Physicians' Health Study, a sample of 4,501
female doctors that serves as a nationally representative sample of all
woman physicians (see sidebar). Current study co-author Erica Frank, assistant
professor in the departments of medicine and family and preventive pedicine,
is principal investigator of the Women Physicians' Health Study. Nanette
Wenger, professor of cardiology, also co-authored the current paper.
"Every woman who is postmenopausal should discuss with her doctor
her own individual risks and benefits of HRT," McNagny said. "HRT
has been shown to relieve hot flashes, decrease a woman's risk of getting
osteoporosis and possibly lower her risk of heart disease and Alzheimer's
disease. However, HRT may increase the risk of breast cancer if used for
more than five to 10 years, and it does have some side effects. By talking
with her doctor, each woman can decide what is best for her."
to March 23, 1998 Contents Page