Clinical Edge

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Trends in Menopausal Hormone Therapy

Menopause; ePub 2018 Dec 21; Crawford, et al

Recommendations for menopausal hormone therapy (MHT) use based on results from the Women’s Health Initiative Study (WHI) were widely adopted after 2002, a recent study showed. Researchers analyzed survey data from up to 14 approximately annual visits over 17 years (1996-2013) from 3,018 participants in the Study of Women’s Health Across the Nation, a prospective cohort study. Logistic regression was used to compare pre- vs post-WHI associations of covariates with MHT initiation and continuation, and to compare pre- vs post-WHI reasons for initiation and continuation. They found:

  • MHT initiation dropped from 8.6% pre-WHI to 2.8% post-WHI, and the corresponding decrease in MHT continuation was 84.0% to 62.0%.
  • Decreases in MHT initiation and continuation occurred across a range of subgroups, consistent with wide dissemination of post-WHI recommendations.
  • However, there were large declines in MHT use in subgroups for whom MHT is often recommended, ie, younger women and those with more vasomotor symptoms.


Crawford SL, Crandall CJ, Derby CA, et al. Menopausal hormone therapy trends before versus after 2002. Impact of the Women’s Health Initiative Study results. [Published online ahead of print December 21, 2018]. doi:10.1097/GME.0000000000001282.