Female Doctors Favor Hormone Therapy for Selves
PHILADELPHIA — Female doctors who have undergone menopause use hormone therapy at nearly twice the rate as other postmenopausal women, according to a new study.
Pills to replace the hormones that women’s bodies no longer produce after menopause have been shown to reduce their risk of heart disease, Alzheimer’s disease, colon cancer and osteoporosis.
But those benefits have been overshadowed in some women’s minds by studies that suggest hormone replacement therapy, or HRT, may also be linked to a higher incidence of breast cancer.
“Women doctors are more likely to use HRT, perhaps because they are most likely to be aware of the benefits and risks of HRT,” said Dr. Sally E. McNagny, an assistant professor of medicine at Emory and lead author of the study.
The study by Emory University researchers, published in the Annals of Internal Medicine, was based on 1,466 postmenopausal participants in the Women Physicians Health Study. It found that 47.4%, 644, were using the replacement therapy at the time of the survey in 1993 and 1994.
Rates of HRT among the general population vary widely--from 8% in Massachusetts to more than 40% on the West Coast--but the national average is 24%, the researchers said in their article, published Dec. 15.
The Women’s Physicians Health Study is a comprehensive study of personal characteristics, attitudes and health-related behaviors in a representative sample of women physicians in the United States.
Other analyses of the study have examined basic demographic and professional characteristics. The Emory team said surveys of female doctors are important because they can accurately describe their own medical histories and they influence the behavior of their patients.
A total of 4,501 female doctors participated in the survey, although most of them were not postmenopausal and were not included in the HRT analysis.
Hormone usage rates were highest among physicians soon after menopause. The researchers found that 60% of their respondents 40 to 49 used HRT, compared with 49% between the ages of 50 and 59 and 36% of those 60 to 70 years old.
A spokesman for the North American Menopause Society, which did not participate in the study, noted the wide variations in HRT use nationally and demographically.
“We reported something like 34% HRT usage in 1993-94, in a Gallup survey,” said Dr. Wulf Utian, executive director of the society.
“If you compared the usage by doctors to that of a group of upper-income women, you would probably find the difference to be not as striking,” Utian said. “But the basic thinking is sound--these are women who have a greater ability to scientifically evaluate the benefits of hormone replacement therapy.
“This is a more informed audience. And, clearly, they have balanced the pros and cons, and are voting with their hormone treatment.”
Because of HRT side effects and the risk of breast cancer, McNagny said, “every woman who is postmenopausal should discuss with her own doctor their own individual risks and benefits of HRT.”
The study was supported in part by grants from the American Medical Assn.’s Education and Research Foundation, the American Heart Assn., a National Institutes of Health research service award, and the Emory Medical Care Foundation.
It also received support from unrestricted grants from Wyeth-Ayerst Laboratories and Solvay Pharmaceuticals Inc.
Wyeth-Ayerst’s estrogen therapy, called Premarin, is the nation’s top-selling drug, with about $1 billion in annual sales. Solvay manufactures Estralab, a low-dose brand of estrogen drug.
