Prevalence and Opinions of Hormone Therapy Prior to the Women's Health Initiative: a Multinational Survey on Four Continents

Objective: Hormone therapy (HT) is a well-established form of treatment for menopausal symptoms worldwide. Since 2002 when the initial findings of the Women's Health Initiative (WHI) were published, the use of HT has decreased dramatically. This investigation was conducted immediately prior to the initial publication of the WHI and Million Women's Study results and quantifies menopausal women's prevalence of symptoms across nine countries on four continents. In addition, it investigates women's positive and negative motivations for HT use as well as their acceptance of various forms and routes of administration.

Methods: Using national representative population panels and quota samples in nine countries on four continents, 10,297 women aged 40-70 years were recruited between April and June 2002. A validated survey was administered to determine which symptoms women suffered from the most and what their desires were regarding the use and effects of HT.

Results: Self-reported symptoms did not differ significantly among menopausal women in Europe, North America, Latin America, and Indonesia. However, the prevalence of HT ever-use ranged from a high of 50% in France to a low of 1.8% in Indonesia (U.S. rate 43%). Oral pills had the highest acceptance rate in all countries.

Conclusions: Women in all parts of the world suffer from symptoms associated with menopause, and many desire treatment. This study was conducted prior to the publication of the initial WHI and Million Women Study results, thereby providing a benchmark of patient attitudes about menopausal symptoms and the acceptability of different types and delivery modes of HT.