[Source – news-medical.net]
A new study published in JAMA Health Forum reveals a significant decline in menopausal hormone therapy (MHT) use among postmenopausal American women over the past two decades. The research underscores the decreasing trends in MHT usage across various racial, ethnic, and age groups, raising concerns about access to treatment for menopausal symptoms.
Approximately 1.3 million women in the U.S. experience menopause annually, with about 80% suffering from cognitive changes, sleep disturbances, genitourinary issues, and vasomotor symptoms such as night sweats and hot flashes. For 30% of these women, the symptoms are severe, making MHT a vital treatment option, especially for genitourinary and vasomotor issues.
MHT prescriptions surged in the 1990s following studies highlighting its cardiovascular benefits. However, its usage began to decline in 2002 after a pivotal clinical trial revealed that MHT did not improve heart health, and its risks might outweigh the benefits. Current clinical guidelines recommend using MHT only for menopausal symptoms, cautioning against its use for chronic disease prevention. These recommendations are based on factors such as hormone type, dosage, timing, and patient age, but further research is still necessary to refine MHT formulations and usage guidelines.
Study Details and Trends
The study analyzed data from the National Health and Nutrition Examination Survey between 1999 and 2020. Researchers examined prescription medications, demographic characteristics, and menopausal status for over 13,000 women. They used this information to track trends in MHT use and explore factors influencing its prevalence.
The data showed a steep decline in MHT use, from 27% of women reporting use in 1999-2000 to less than 5% in 2017-2020. The sharpest decline was among women aged 52 to 65, who previously reported the highest usage rates. This decrease was seen across all racial and ethnic groups, with non-Hispanic White women experiencing the sharpest drop, from 31% to 6%. Menopausal hormone therapy (MHT) usage also fell among Hispanic and non-Hispanic Black women, with declines from 14% to 3% and from 12% to less than 1%, respectively.
Implications and Future Research
The truth about hormone therapy for menopause
The study highlights critical disparities in MHT usage among different racial and ethnic groups, particularly non-Hispanic Black women, who are less likely to receive treatment despite experiencing more severe and prolonged menopausal symptoms. The research suggests that factors such as income, education, insurance coverage, and body mass index influence menopausal hormone therapy (MHT) use. Notably, Hispanic women who smoked were more likely to use MHT, while the opposite trend was seen among non-Hispanic White women.
These findings echo similar trends in countries like the U.K., Korea, Germany, and Australia, signaling the need for further research to develop safer, more effective MHT options. Ensuring equitable access to treatment for women across different income levels, educational backgrounds, and racial and ethnic groups remains a priority for future studies.
