1
|
Hormonal contraception and postmenopausal hormone therapy in Spain: time trends and patterns of use. Menopause 2016; 22:1138-46. [PMID: 26125537 DOI: 10.1097/gme.0000000000000487] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aims to describe time trends in and patterns of use of hormonal contraception and postmenopausal hormone therapy and to identify factors associated with their use among Spanish women. METHODS We performed a cross-sectional analysis using data from 1,954 population controls (aged 24-85 y) in 12 provinces of Spain who were enrolled in the Multi Case-Control Spain study (2007-2013). Data were collected from a questionnaire conducted face-to-face by trained personnel. We collected information on sociodemographic factors, lifestyle, sleep patterns, reproductive history, and occupational history. RESULTS Overall, 48.5% of Spanish women reported ever use of hormonal contraception, and 9.8% of women in the postmenopausal group reported use of postmenopausal hormone therapy. Younger cohorts used hormonal contraception for a longer period, whereas postmenopausal hormone therapy use dramatically dropped in the 2000s. Women with higher education levels (including education of partners) and smoking history were the most probable users of hormonal contraception, whereas inverse associations were observed among housewives, obese women, and nulliparous women. Postmenopausal hormone therapy use was associated with a surgical or therapeutic cause of menopause and with occupational history of rotating shifts. CONCLUSIONS In this Spanish population, several demographic, lifestyle, occupational, and reproductive factors are associated with use of hormonal compounds. Characterizing hormonal users and monitoring trends in the use of these hormonal compounds are essential from a public health perspective.
Collapse
|
2
|
Jalava-Broman J, Mäkinen J, Sillanmäki L, Vahtera J, Rautava P. Characteristics associated with initiation of hormone replacement therapy among Finnish women: A register-linkage study. Maturitas 2016; 89:73-8. [DOI: 10.1016/j.maturitas.2016.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/19/2016] [Accepted: 04/08/2016] [Indexed: 12/12/2022]
|
3
|
Mourits MJ, de Bock GH. Survival benefit of epithelial ovarian cancer in hormone replacement therapy users: Could it be explained by socio-economic status? Maturitas 2016; 86:26-7. [DOI: 10.1016/j.maturitas.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 01/06/2016] [Indexed: 11/16/2022]
|
4
|
Başer M, Taşci S. Reasons Why Women in Turkey Prefer Short-Term Use of Hormone Replacement Therapy (HRT). Health Care Women Int 2013; 34:1035-48. [DOI: 10.1080/07399332.2012.695829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
5
|
Arabshahi S, Lahmann PH, Williams GM, Marks GC, van der Pols JC. Longitudinal change in diet quality in Australian adults varies by demographic, socio-economic, and lifestyle characteristics. J Nutr 2011; 141:1871-9. [PMID: 21865564 DOI: 10.3945/jn.111.140822] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Knowledge of determinants of change in diet quality is needed, but it is relatively limited to date and mostly available from cross-sectional studies. We investigated longitudinal change in diet quality and its associations with period of birth (birth cohort) and socio-demographic and lifestyle characteristics. We used dietary intake data collected by FFQ in 1992, 1996, and 2007 from a population-based random sample of adults comprising 1511 men and women aged 25-75 y at baseline and applied generalized estimating equations to examine determinants of long-term change in diet quality, calculated using a diet quality index reflecting dietary guidelines for Australian adults. Information on socio-demographic and lifestyle factors was derived from self-reported questionnaires. Multivariable models, stratified by sex, were adjusted for confounders. We showed that there was an overall increase in diet quality in both men and women, but scores related to intake of fruit (men only), cereals, and food variety decreased during a 15-y follow-up. Younger age, higher occupational level (men only), and low to medium level of physical activity and hormone replacement therapy use in women were independently associated with greater improvement in diet quality over time (P < 0.05). In conclusion, despite an overall improvement in diet quality over time, this study suggests that efforts to further improve diet quality in Australia should focus on increasing consumption of fruit, cereals, and a greater variety of foods. More evidence from studies that assess change in dietary quality in longitudinal studies is needed to corroborate these findings.
Collapse
Affiliation(s)
- Simin Arabshahi
- Queensland Institute of Medical Research, Cancer and Population Studies, Herston, Brisbane, Australia
| | | | | | | | | |
Collapse
|
6
|
Fabre A, Fournier A, Mesrine S, Ringa V, Clavel-Chapelon F. [Characteristics and determinants of initiation of premenopausal use of oral progestagens in the French E3N cohort]. ACTA ACUST UNITED AC 2010; 39:310-7. [PMID: 20452148 DOI: 10.1016/j.jgyn.2010.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 03/23/2010] [Accepted: 03/29/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To describe the characteristics and determinants of initiation of use of progestagens alone - i.e. without concomitant use of estrogen - among French premenopausal women. METHODS Forty-one thousand six hundred and three women from the French E3N cohort were included in our analyses. Prevalence of use was calculated from 1992 to 2005. Determinants of progestagens alone initiation were investigated prospectively from 1992 to 2005, using multivariable Cox proportional hazards models. RESULTS Fifty-eight per cent of women who had reached menopause between 1992 and 2005 ever used progestagens alone during their premenopause. Between 1992 and the end of 1990s, the increase in the prevalence of progestagens alone use in our cohort was close to 50%. Initiation of progestagens alone was significantly associated with a high level of education (postgraduate compared to high-school graduate: Hazard ratio [HR]: 1.09 95% confidence interval [CI]: 1.01-1.18), with a normal body mass index (overweight and obese women compared to normal-weight women: HR=0.84, 95% CI: 0.79-0.90 and HR=0.79, 95% CI: 0.69-0.89 respectively), history of gynecological disorders (mastalgia, benign breast disease and benign uterine or ovarian disease [HR=1.38, 95% CI: 1.27-1.49, HR=1.18, 95% CI: 1.13-1.24 and HR=1.60, 95% CI: 1.52-1.68 respectively]) and with recent gynaecological screening (as measured by recently performed mammogram or Pap smear HR=1.11, 95% CI: 1.05-1.17 and HR=1.38, 95% CI: 1.27-1.49 respectively). CONCLUSION Since, at least in France, use of progestagens alone at premenopause is common, evaluation of its risks and benefits is of public health importance.
Collapse
Affiliation(s)
- A Fabre
- Inserm (Institut national de la santé et de la recherche médicale), ERI 20, institut de cancérologie Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif, France
| | | | | | | | | |
Collapse
|
7
|
Du Y, Scheidt-Nave C, Schaffrath Rosario A, Ellert U, Dören M, Knopf H. Changes of menopausal hormone therapy use pattern since 2000: results of the Berlin Spandau Longitudinal Health Study. Climacteric 2010; 12:329-40. [PMID: 19437194 DOI: 10.1080/13697130902745120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND There are virtually no prospective cohort studies in Germany regarding the changes of menopausal hormone therapy (HT) use pattern and factors associated with HT discontinuation after the release of the Women's Health Initiative (WHI) trial results. METHODS We assessed HT prevalence and use pattern as well as factors associated with HT discontinuation in a cohort of 903 women 40 years of age and older, who participated in two consecutive follow-up visits in a 20-year prospective health study from July 2000 to February and from August 2002 to December 2004. RESULTS Overall, the prevalence of HT users in the cohort declined significantly from 35.4% in 2000-2002 to 22.5% in 2002-2004. Adjusting for aging of the population, a statistically significant decrease in HT user prevalence was consistently observed across subgroups of HT users defined by type and duration of HT use. The decline was most pronounced with respect to women using combined estrogen-progestin regimens (-10.5%), higher-dose estrogens (-11.6%), oral preparations (-11.1%), as well as long-term HT users (-8.4%). The prevalence of women indicating HT use for climacteric symptoms decreased significantly (-12.4%), whereas the prevalence of women reporting use of HT for the prevention of osteoporosis increased (+1.8%) significantly. Irrespective of hysterectomy status, half of the women who continued HT changed their HT preparations and switched to lower estrogen doses (11.5%), topical estrogens (8.2%), or phytohormones (3.8%). We did not observe any significant differences between women who continued and discontinued HT regarding health-related characteristics of the study population as of 2000-2002. However, women seeing a gynecologist in the 12 months preceding the 2002-2004 visit were significantly less likely to discontinue HT use in bivariate and multivariate analyses. CONCLUSIONS Substantial declines in HT user prevalence as well as changes in HT use patterns to lower-dose estrogen preparations and non-oral routes of administration are likely to reflect effects of the publication of the WHI results. Consulting a gynecologist appeared to be relevant for a woman's decision to continue HT.
Collapse
Affiliation(s)
- Y Du
- Department of Epidemiology and Health Monitoring, Division of Non-Communicable Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | | | | | | | | |
Collapse
|
8
|
Øren A. Motives for initiation, temporary discontinuation, and permanent discontinuation of hormone replacement therapy use among Norwegian women. Maturitas 2009; 64:33-7. [DOI: 10.1016/j.maturitas.2009.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 07/02/2009] [Accepted: 07/03/2009] [Indexed: 11/29/2022]
|
9
|
Heier M, Moebus S, Meisinger C, Jöckel KH, Völzke H, Döring A, Alte D. Menopausal hormone therapy in Germany. Results of three national surveys from 1997 to 2003. Maturitas 2008; 62:9-15. [PMID: 19028032 DOI: 10.1016/j.maturitas.2008.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Revised: 09/25/2008] [Accepted: 10/02/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine regional variations in the prevalence and applied therapy regimes of current menopausal hormone therapy (HT) in Germany. METHODS Three population-based surveys, analysing data of 45-74 years old women, were compared: The Study of Health in Pomerania (SHIP; 1123 participants; northeast Germany, October 1997-May 2001), Cooperative Health Research in the Augsburg Region Survey 2000 (KORA; 1253 participants; south Germany, October 1999-April 2001) and Heinz Nixdorf Recall Study (HNR; 2257 participants; west Germany, December 2000-August 2003). A standardized interview technique provided data on current medication. RESULTS The age-standardized prevalence of HT was 17.0% (95% confidence interval (CI): 14.9-19.1) in SHIP, 25.9% (95% CI: 23.6-28.3) in KORA and 24.7% (95% CI: 22.9-26.4) in HNR. Mean average time of intake of HT was 5.1 (SHIP), 7.5 (KORA) and 10.1 years (HNR). The use of estrogen plus progestogen combinations was equally common in all three surveys with proportions of about 15%, the use of unopposed estrogen in KORA and HNR was twice as high as in SHIP. In all three surveys oral estradiol was taken most often. Transdermal estradiol was preferred by KORA women whereas conjugated estrogens were taken most frequently by HNR women. CONCLUSIONS Compared to northeast Germany HT was more often applied in the south and west of Germany. HT as long-term therapy was more common in West than in East Germany. In each study region there was a specific pattern of used HT components.
Collapse
Affiliation(s)
- Margit Heier
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany.
| | | | | | | | | | | | | |
Collapse
|
10
|
Du Y, Melchert HU, Schäfer-Korting M. Use of oral contraceptives in Germany: Prevalence, determinants and use-associated health correlates. Eur J Obstet Gynecol Reprod Biol 2007; 134:57-66. [PMID: 17320266 DOI: 10.1016/j.ejogrb.2007.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Revised: 12/12/2006] [Accepted: 01/12/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe oral contraceptive (OC) use, its determinants and use-associated health correlates from 1984 to 1999 in Germany. STUDY DESIGN Cross-sectional comparison was performed for socioeconomic factors, personal lifestyle and use-associated health correlates between 1862 OC users and 2625 age-matched nonusers identified from five German National Health Surveys. Regression models were used to obtain the determinants of OC use. RESULTS While in women aged 25-49 years OC use remained nearly constant in the western part of Germany from 1984 to 1999 (17.3-20.1%), it declined greatly in the eastern part from 43.0% in 1991 to 32.3% in 1999. Cross-sectional comparison and regression analysis suggested that OC users did not differ from nonusers in most selected personal and socioeconomic factors. OC users showed generally a better health profile than age-matched nonusers with more satisfaction with health, higher quality of life and no significant difference in history of cardiovascular diseases despite slightly higher prevalence of hypertension and hyperlipidemia that are of little clinical significance. CONCLUSIONS OC use seems to be generally safe. Whether the better health profiles found in OC users are the results of OC use or effects of healthy users, or both, should be further studied.
Collapse
Affiliation(s)
- Yong Du
- RKI 22, Pharmacoepidemiology, Robert-Koch Institute, Seestr. 10, D-13353 Berlin, Germany
| | | | | |
Collapse
|
11
|
Schwarz S, Völzke H, Baumeister SE, Hampe J, Dören M. Menopausal hormone therapy and gallbladder disease: the Study of Health in Pomerania (SHIP). Clin Endocrinol (Oxf) 2007; 67:51-9. [PMID: 17437513 DOI: 10.1111/j.1365-2265.2007.02834.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Several studies suggest that oral menopausal hormone therapy (MHT) is associated with an increased risk of gallbladder disease. It has been hypothesized that nonoral MHT may reduce the risk of cholelithiasis. The objective of the present study was to analyse the association between (1) use of life-time MHT (ever use) and gallbladder disease and (2) nonoral use of MHT and gallbladder disease. DESIGN Cross-sectional study using population-based data from the Study of Health in Pomerania (SHIP). POPULATION The study population included 994 postmenopausal women, aged 40-79 years. The subgroup of current oral and nonoral MHT users comprised 139 women. METHODS AND MEASUREMENTS Sociodemographic, medical and reproductive characteristics were based on computer-assisted personal interviews, and selected laboratory parameters were analysed. Gallbladder disease was defined by either a prior history of cholecystectomy or the presence of current sonographically diagnosed gallstones. Data analyses consisted of descriptive, bivariable and multivariable procedures. We performed Poisson regression with Huber/White standard errors to investigate the association between ever use, current nonoral use of MHT and gallbladder disease. RESULTS We found no significant association between ever use of MHT and gallbladder disease and sonographically diagnosed gallstones in fully adjusted analyses. Women who used MHT had a significantly higher risk for cholecystectomy compared to nonusers. There was no association between nonoral use of MHT and gallbladder disease. CONCLUSIONS Our analyses do not lend support to the hypothesis that use of MHT is associated with gallbladder disease.
Collapse
Affiliation(s)
- S Schwarz
- Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Clinical Research Centre of Women's Health, Berlin, Germany.
| | | | | | | | | |
Collapse
|
12
|
Kropp S, Terboven T, Hedicke J, Mutschelknauss E, Slanger T, Braendle W, Berger J, Chang-Claude J, Flesch-Janys D. Good agreement between physician and self-reported hormone therapy data in a case-control study. J Clin Epidemiol 2007; 60:1280-7. [PMID: 17998083 DOI: 10.1016/j.jclinepi.2007.02.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2006] [Revised: 02/12/2007] [Accepted: 02/15/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In a population-based case-control study examining the effects of postmenopausal hormone therapy (HT) on breast cancer risk, the authors conducted a validation study comparing prescription data from gynecologists with self-reports. STUDY DESIGN AND SETTING The study was conducted in the Rhein-Neckar and Hamburg regions of Germany from 2002 to 2005. A total of 224 cases and 225 controls, stratified by region, age, and hormone use were randomly selected for the validation study. RESULTS For ever/never use 88.2% agreement was seen, and agreement for ever/never use by type of HT was 80.6%, 80.3%, and 90.5% for mono-estrogen, cyclical combined, and continuous combined therapy, respectively. The intraclass correlation coefficient (ICC) for duration of use was high, 0.82 (95% confidence interval [CI]: 0.77, 0.85), as were the ICCs for age at first and last use, 0.88 (95% CI: 0.85, 0.91) and 0.98 (95% CI: 0.97, 0.98). Despite the exceptionally high number of different HT prescriptions available in Germany, comparison of exact brand name resulted in perfect agreement for 50.2% of participants, partial agreement for 29.3%, and no agreement for 20.7%. In general, agreement was not differential by disease status. CONCLUSION Overall, the self-reported HT of the study participants corresponded well with physicians' reports.
Collapse
Affiliation(s)
- S Kropp
- Department of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Lucas R, Barros H. Life prevalence and determinants of hormone replacement therapy in women living in Porto, Portugal. Maturitas 2007; 57:226-32. [PMID: 17293067 DOI: 10.1016/j.maturitas.2006.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Revised: 12/07/2006] [Accepted: 12/27/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To survey the life prevalence and determinants of hormone replacement therapy (HRT) in Portugal. METHODS We evaluated 908 women with mean age (standard deviation) 62.3 (9.6) years, as part of the assembling of a cohort of adults, representative of Porto inhabitants. Extensive data collection was conducted and included socio-demographic, lifestyle and clinical characterisation. The latter comprised gynecologic and obstetric history, as well as lifetime use and duration of HRT. RESULTS Life prevalence of hormone replacement therapy was 26.8% (95% confidence interval: 23.9-29.8). Prevalence of lifetime HRT was higher in younger (born after 1949: 37.1%) and more educated women (over 12 schooling years: 48.7%), as in white-collar workers (36.8%), and women using private healthcare (39.4%). HRT use was also more frequent among ever smokers (43.1%), and in women reporting regular sports practice (35.6%). Ever users of oral contraceptives underwent HRT more frequently (33.3%) and women who experienced menopause more recently were more likely to use HRT (after 1994: 40.5%). No differences were found in the prevalence of HRT according to whether women had been hysterectomised or oophorectomised. Education, regular sports practice and menopause year were independent determinants of HRT. Median duration of therapy was 2 years. Short-term HRT users were more educated, and had more recent menopause. Long-term HRT users were more educated, engaged in sports more frequently, and were more frequently oophorectomised. CONCLUSIONS Prevalence of hormone replacement therapy increased until 2001 and was mainly determined by high socioeconomic status, regardless of important therapeutic indications, such as oophorectomy and hysterectomy.
Collapse
Affiliation(s)
- Raquel Lucas
- Department of Hygiene and Epidemiology, University of Porto Medical School, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal.
| | | |
Collapse
|
14
|
Nagel G, Lahmann PH, Schulz M, Boeing H, Linseisen J. Use of hormone replacement therapy (HRT) among women aged 45-64 years in the German EPIC-cohorts. Maturitas 2006; 56:436-46. [PMID: 17194554 DOI: 10.1016/j.maturitas.2006.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 11/01/2006] [Accepted: 11/22/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe the prevalence and to assess type and indicators of hormone replacement therapy (HRT) use in the two German EPIC-cohorts. METHODS Approximately 30,000 women predominantly aged 35-65 years were recruited in EPIC-Heidelberg and EPIC-Potsdam between 1994 and 1998. Information on diet and lifestyle, medical history and use of hormone therapy was collected at recruitment. Prevalence and type of HRT-regime was described and logistic regression models used to examine correlates of HRT-use. RESULTS Among women aged 45-64 years, 37.9% in Heidelberg and 35.8% in Potsdam were current HRT users. Among current users without bilateral oophorectomy, 40.5% in Heidelberg and 23.7% in Potsdam used HRT for at least 5 years. Most women in Heidelberg were taking cyclic combined or estrogen monotherapy, whereas in Potsdam both continuous combined and cyclic combined therapies were most frequently used. In both centres, older age, ever use of oral contraceptives, and alcohol consumption were indicators for both current and ever HRT-use. HRT-use was less frequent in obese women as compared to women with lower BMI. In Potsdam, but not in Heidelberg, higher education and current smoking were associated with HRT-use. CONCLUSION In both German EPIC-cohorts, the prevalence of medication with HRT is high compared to other European countries. Types of exogenous hormones used differed by centre. Various reproductive and lifestyle characteristics were identified as correlates of HRT-use.
Collapse
Affiliation(s)
- Gabriele Nagel
- Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany.
| | | | | | | | | |
Collapse
|