Perimenopausal knowledge of mid-life women in northern Taiwan

Determinants of Hormone Replacement Therapy Knowledge and Current Hormone Replacement Therapy Use

Background: The use of hormone replacement therapy (HRT) to treat menopausal symptoms has declined since the early 2000s, and little is known about the contemporary determinants of use in the United States. We aim to understand women's knowledge of HRT as a treatment of menopausal symptoms and to assess the factors associated with HRT use. Materials and Methods: Weighted multivariate logistic regression models evaluated the correlates of high HRT knowledge and current HRT use among a sample of 2,548 women aged ≥45 years who participated in an online survey between August 2019 and May 2020. Results: In total, 82% of the women surveyed reported experiencing one or more menopausal symptoms, yet only 10.5% reported using HRT. Only 33% reported high HRT knowledge. The odds of reporting high HRT knowledge increased with increasing age. Racial, ethnic minority women were less likely to report high HRT knowledge (adjusted odds ratio [AOR] = 0.69; 95% confidence interval [CI] = 0.5-0.9). Hispanic and non-Hispanic women of other racial and ethnic groups were less likely to use HRT compared with non-Hispanic White women (AOR = 0.3; 95% CI = 0.1-0.6) (AOR = 0.4; CI = 0.2-0.9), respectively. Women experiencing irregular periods were less likely to report current HRT use (AOR = 0.1, 95% CI = 0.4-0.7). Compared with past users, never users appeared to be more risk averse, and reported concern over HRT risks and side effects as reasons for nonuse. Conclusions: Many factors impact women's perceived HRT knowledge level and to a lesser extent HRT use. Future research should better define the most important factors influencing decisions to use HRT for symptom relief.

The longitudinal effects of a perimenopausal health education intervention on the mid-life women in Taiwan

OBJECTIVES

The study purpose was to evaluate the longitudinal effects, after 3 months and 1-year, of a perimenopausal health education intervention for mid-life women in Taiwan.

METHODS

This study was conducted at two hospitals and their neighborhood communities (each included three subgroups, traditional Chinese, gynecologic and neighborhood communities), using a parallel-design, control trial for mid-life women. There were three instruments: (1) the Perceived Uncertainty Scale, (2) the Perceived Perimenopausal Disturbances Scale and (3) the Practice of Health Behaviors Scale. The intervention effects from the study baseline to a 1-year follow-up were estimated using the mixed effect model (SAS-MIXED procedure) for repeated measures of health behaviors, perceived uncertainty and perceived perimenopausal disturbances.

RESULTS

A total of 161 women were in the education group, while 174 women were in the control group. After a 1-year follow-up, health education intervention had significantly increased the practice of health behavior in both Chinese medicine subgroups (beta=15.39, P<0.001) and gynecologic clinics subgroup (beta=10.08, P<0.005). On the other hand, health education intervention had significantly decreased perceived uncertainty in subgroups of Chinese medicine (beta=-9.52, P<0.005).

CONCLUSIONS

The perimenopausal health education had positive effects in reducing perceived uncertainty and increasing practice of health behavior among women from Chinese medicine clinics after a 1-year follow-up. Women from the gynecologic clinics showed the intervention effects of increasing health behavior after a three month and 1-year follow-ups. However, the women from neighborhood communities did not show any significant intervention effects at follow-ups. It is important to urge the women from communities to promote health practices for their perimenopausal transition instead of just living with their changing health.

Traditional Chinese medicine--what are we investigating? The case of menopause

CAM researchers commonly treat traditional medicines as unchanging systems. This article questions the validity of this approach by examining the treatment of menopausal syndrome by traditional Chinese medicine (TCM). Such treatment strategies were invented in 1964 and betray a strong influence of biomedical thinking. While they determine TCM treatment of menopausal syndrome in the West, physicians in China and Japan use many other treatment strategies from within the wider Chinese medical tradition in clinical practice. Cultural variability in the manifestation of menopausal syndrome furthermore questions the usefulness of simply importing treatment strategies from China to the West. This leads me to conclude that Chinese medicine as such can never be evaluated by means of clinical research. What we can do is use Chinese medicine as a resource for thinking about illness, and for formulating clinical interventions that may then be assessed using methods of evidence based research.