Correlates of Postmenopausal Estrogen Use and Trends through the 1980s in Two Southeastern New England Communities

Derby, Carol A.; Hume, Anne L.; Barbour, Marilyn M.; McPhillips, Janice B.; Lasater, Thomas M.; Carleton, Richard A.

doi:10.1093/oxfordjournals.aje.a116616

Cited by 124 publications

(51 citation statements)

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“…For a factor to confound an association, though, it needs to be associated with the exposures of interest, here postmenopausal oestrogen and SHBG levels, in addition to being associated with disease. Women who use hormone replacement therapy tend to be leaner, suggesting that they may have lower oestrogen levels than women who do not use them (Derby et al, 1993). However, in our dataset there was no evidence of a difference in age-adjusted levels of sex hormones or SHBG between control subjects who had and had not used hormone replacement therapy.…”

Section: Discussioncontrasting

confidence: 54%

Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study

et al. 2001

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SummaryWe assessed the association of postmenopausal serum levels of oestrogens and sex hormone-binding globulin (SHBG) with endometrial cancer risk in a case-control study nested within the NYU Women's Health Study cohort. Among 7054 women postmenopausal at enrolment, 57 cases of endometrial cancer were diagnosed a median of 5.5 years after blood donation. Each case was compared to 4 controls matched on age, menopausal status at enrolment, and serum storage duration. Endometrial cancer risk increased with higher levels of oestradiol (odds ratio = 2.4 in highest vs lowest tertile, P for trend = 0.02), percent free oestradiol (OR = 3.5, P < 0.001), and oestrone (OR = 3.9, P < 0.001). Risk decreased with higher levels of percent SHBG-bound oestradiol (OR = 0.43, P = 0.03) and SHBG (OR = 0.39, P = 0.01). Trends remained in the same directions after adjusting for height and body mass index. A positive association of body mass index with risk was substantially reduced after adjusting for oestrone level. Our results indicate that risk of endometrial cancer increases with increasing postmenopausal oestrogen levels but do not provide strong support for a role of body mass index independent of its effect on oestrogen levels.

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Section: Discussioncontrasting

confidence: 54%

Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study

et al. 2001

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“…The strongest biological determinant of use of HT is surgical menopause (Derby et al 1993;Egeland et al 1988;Standeven et al 1986;Stadel and Weiss 1975;Rosenberg et al 1979;Johannes et al 1994). The presence of menopausal symptoms, such as hot flashes and excessive sweating, are other biological factors found to be correlated with HT use (Stadel and Weiss 1975;Johannes et al 1994).…”

Section: The Correlates Of Hormone Therapymentioning

confidence: 99%

“…The presence of menopausal symptoms, such as hot flashes and excessive sweating, are other biological factors found to be correlated with HT use (Stadel and Weiss 1975;Johannes et al 1994). Health behavior indicators, such as exercise, alcohol consumption, smoking, and body mass index have also been associated with HT (Egeland et al 1988;Johannes et al 1994;Stampfer and Colditz 1991;Matthews et al 1996a;Barrett-Connor, Wingard, and Criqui 1989;Derby et al 1993). However, it seems unlikely that these behaviors actually cause HT use.…”

Section: The Correlates Of Hormone Therapymentioning

confidence: 99%

“…Two competing explanations for the observed relationship between husband's occupational status and women's HT use are discussed: HT as a preventive health behavior and HT as a socially influenced behavior to help maximize femininity. Prevalence estimates of HT use have ranged widely depending upon the sampling frame of the study (Derby et al 1993; Johannes et al 1994;Thompson 1995). Rates of prescribing HT in the U.S. have been found to be highest in the West and lowest in the East (Hemminki et al 1988).…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Status Differences in Hormone Therapy

Marks

Shinberg

1998

American Journal of Epidemiology

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The relative benefits and hazards of noncontraceptive hormone therapy (HT) for aging women remain a controversial medical and social issue. This study examined the lifetime incidence of HT use, how usage varied by surgery status, and the bivariate and net associations between a large array of SES indicators and the likelihood of midlife women ever using HT by age 53-54 among N=3,612 non-Hispanic white women participants in the Wisconsin Longitudinal Study . About half the sample of women had ever used HT; 79% who had ever used HT were currently using HT (38.5%). In multivariate logistic regression analyses, the most robust SES predictor of HT use was a woman's husband's occupational status (higher status associated with higher rates of use). This association withstood adjusting for all other measured sociological and biomedical factors (e.g., other health behaviors, menopausal symptoms, age at menopause, health insurance). The association of HT use and education differed for women who underwent hysterectomy and/or oophorectomy (where the odds of using HT were higher for less educated women) and for women with intact reproductive organs (where the odds of using HT were lower for less educated women). Only among women who had surgery was the association of education with use of HT persistent adjusting for all other measured factors. Additionally, a woman's own earnings and household net worth showed positive net associations with HT use. Two competing explanations for the observed relationship between husband's occupational status and women's HT use are discussed: HT as a preventive health behavior and HT as a socially influenced behavior to help maximize femininity. Prevalence estimates of HT use have ranged widely depending upon the sampling frame of the study (Derby et al. 1993; Johannes et al. 1994;Thompson 1995). Rates of prescribing HT in the U.S. have been found to be highest in the West and lowest in the East (Hemminki et al. 1988). The use of HT is not random. While the most significant sociodemographic correlate of HT use other than age and gender is socioeconomic status (SES), SES has not been examined systematically in most studies of HT. SES is generally found to be positively associated with health-promoting behaviors and good health outcomes for both women and men (Adler et al. 1993;House et al. 1990House et al. , 1994Feinstein 1993; Longino, Warheit, and Green 1989; Marmot, Kogevinas, and Elston 1987;Syme and Berkman 1976;Waldron 1991). Yet considerable public health debate continues regarding the mechanisms and processes whereby SES influences differences in health behaviors and health status (Adler et al. 1993;Andersen 1995; Link and Phelan 1995). SES is measured in different ways -e.g., years of education, occupational status, and income. Different measures of SES tend to be only moderately correlated, and each captures different attributes of social status. One research approach to help elucidate the possible processes underlying any given relationship between a health outcome and S...

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“…46 In contrast, one quarter of the white women had been offered HRT, but their attitudes toward medical intervention tended to be less favorable with increasing education; our findings are limited by the fairly homogeneously welleducated sample. Some studies suggest that college-educated women are more likely to attribute psychological symptoms to life stressors than a biomedical model and prefer "natural therapy" to HRT 30 ; that they are more concerned about the potential risk of breast cancer than of heart disease, and rate their risk of breast cancer far higher 27 ; and that perceived risk of malignancy plays a much greater role in women's decisions about HRT than perceived risk of menopause-related sequelae. 47 The latter was corroborated in focus groups.…”

Section: Discussionmentioning

confidence: 99%

Ovarian Aging and Hormone Replacement Therapy Hormonal Levels, Symptoms, and Attitudes of African-American and White Women

1997

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OBJECTIVES:To characterize reproductive hormone levels, symptoms, and attitudes related to menopause among healthy, menstruating white and African-American women aged 44 to 49 years. DESIGN: Pilot study; cross-sectional survey. SETTING:Community-based convenience sample of women in the Philadelphia metropolitan area. PARTICIPANTS:Thirty-three African-American and 35 white women. MEASUREMENTS:The survey instrument collected demographic data, medical and reproductive history, health practices and behaviors. It included previously validated function, depression, and quality-of-life instruments, and a Menopause Attitude Scale that included two factors, attitudes toward the menopause and attitudes toward medical therapy. Anthropometric measurements were taken at enrollment, and reproductive hormones and daily symptom logs were followed over two menstrual cycles. MAIN RESULTS:The two groups were comparable in mean age (African-American 46.2 years, white 46.9 years). Serum levels of estradiol, follicle-stimulating hormone, dihydroepiandrosterone-sulfate, and progesterone were comparable. Symptoms were similar in type and frequency. However, the African-American women had significantly more positive attitudes toward menopause, were more likely to rely on family for information about menopause, and were less likely to have been recommended hormone replacement therapy by their physicians. A majority of women in each group expressed satisfaction with the care they had received. he decline of ovarian function among women in their thirties and forties has been implicated in the development of physiologic changes that are widely observed a decade later, including body mass and composition, osteoporosis, cardiovascular disease, and psychological distress. Existing data regarding normal reproductive aging derive primarily from white, reproductive-age women with infertility, 1 postmenopausal women, 2 or small clinical samples of women seeking medical treatment. 3,4 It is not known whether the pattern of hormonal changes are similar in African-American and white women. African-American women have higher rates of obesity, cardiovascular disease, and stroke, 5,6 but lower rates of osteoporosis and vertebral or hip fractures. 7,8 Several studies have shown that menopausal symptoms vary across cultural groups 9,10 and socioeconomic strata 9,11,12 and can be linked to differing societal attitudes toward women's changing roles during and after menopause. [13][14][15][16][17][18][19][20] The overall prevalence of affective disorders is slightly less in African-American women than white women, 21 and postmenopausal African-American women are less frequently diagnosed with depression. 22 Similarly, attitudes toward hormone replacement therapy (HRT) might vary among cultural groups. Most recent investigations of HRT use have involved primarily white women. [23][24][25][26][27][28][29][30][31] The aims of this preliminary study were to assess the physiologic and clinical characteristics of healthy premenopausal African-American and white wo...

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Correlates of Postmenopausal Estrogen Use and Trends through the 1980s in Two Southeastern New England Communities

Cited by 124 publications

References 0 publications

Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study

Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study

Socioeconomic Status Differences in Hormone Therapy

Ovarian Aging and Hormone Replacement Therapy Hormonal Levels, Symptoms, and Attitudes of African-American and White Women

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