Emory Report

March 23, 1998

 Volume 50, No. 25

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 less likely."

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."

-Lorri Preston

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