Knowledge, Perceptions and Information about Hormone Therapy (HT) among Menopausal Women: A Systematic Review and Meta-Synthesis

Abstract

BackgroundThe use of hormone therapy (HT) by menopausal women has declined since the Women's Health Initiative randomized trial (WHI) in 2002 demonstrated important harms associated with long-term use. However, how this information has influenced women's knowledge and attitudes is uncertain. We aimed to evaluate the attitudes and perceptions towards HT use, as well as specific concerns and information sources on HT since the WHI trial.Method/ResultsWe did a systematic review to assess the attitudes and knowledge towards HT in women, and estimate the magnitude of the issue by pooling across the studies. Using meta-synthesis methods, we reviewed qualitative studies and surveys and performed content analysis on the study reports. We pooled quantitative studies using a random-effects meta-analysis. We analyzed 11 qualitative studies (n = 566) and 27 quantitative studies (n = 39251). Positive views on HT included climacteric symptom control, prevention of osteoporosis and a perceived improvement in quality of life. Negative factors reported included concerns about potential harmful effects, particularly cancer risks. Sources of information included health providers, media, and social contact. By applying a meta-synthesis approach we demonstrate that these findings are broadly applicable across large groups of patients.ConclusionsAlthough there are clear hazards associated with long-term HT use, many women view HT favorably for climacteric symptom relief. Media, as a source of information, is often valued as equivalent to health providers.

Knowledge and Attitude towards Menopause and Hormone Replacement Therapy in Chinese Women

“…Apart from cultural differences, the reasons were considered to be the lower prevalence and less severity of menopausal symptoms in the Asian population [23,31]. Our prior meta-analysis estimated that 15% of women on HRT followed a physician's prescription [17]. Our current study, however, reports 57% (95% CI: 41-77%) of Chinese women used HRT following a prescription.…”

“…Part two collected information about the knowledge and prevalence of menopausal symptoms according to the items raised by the modified Kupperman menopause index [1]. Part three collected information about the knowledge of HRT designed according pertinent items from the previously conducted meta-analysis [17]. Finally, part four collected information on previous or current HRT use, reasons for use and side effects of HRT.…”

“…Our findings indicate that many women still viewed HRT as favorable for climacteric symptom relief despite the potential hazard of breast cancer normally associated with its long-term use [17]. However, the majority of studies included in this review were conducted in western countries.…”

Hot flushes, hormone therapy and alternative treatments: 30 years of experience from Sweden

“…It seems that middle-aged women have limited knowledge about the menopausal transition and HT (24, 25), which makes it difficult for them to evaluate the alternative choices of treatment.…”

Ayurveda for Menopause

“…With the chemical, physical and mental changes taking place, a shift in the doshas will magnify the intensity and numbers of symptoms, signifying that balance and awareness need to be restored to the body and mind. Some studies confirm that an individual's lifestyle affects the risk of diseases during the perimenopausal period [12][13].…”