: a cross-sectional community study of Australian women
The main outcome measures were use of prescription therapies for menopausal symptoms and the Menopause-specific Quality of Life questionnaire. A total of 5850 women were invited (by telephone) to participate: 2911 agreed to participate, and 2020 completed questionnaires were returned. Demographic characteristics show that participants were representative of all Australian women of this age. For this analysis, only 1491 perimenopausal and postmenopausal women were included. Moderate to severe vasomotor symptoms (VMS) were reported by 17% of women, and 18.3% of women reported moderate to severe sexual symptoms. Among all participants, 11.3% used hormone therapy, mostly oral estrogen (68.5%). Among all women, 1.1% used compounded estrogen and/or compounded progesterone, 0.9% used androgen therapies (dehydroepiandrosterone or testosterone), 0.9% used tibolone, 0.9% used non-hormone therapies, and 4.5% used vaginal estrogen. Hormone therapy use was associated with surgical menopause (adjusted odds ratio, AOR 3.27; 95% CI 2.0–5.44), and moderate-severe psychological symptoms (AOR 1.83; 95% CI 1.19–2.80. Current smoking (AOR 0.53; 95% CI 0.29–0.96) and a BMI ≥ 40 (AOR 0.35; 95% CI 0.14–0.87) were inversely associated with hormone therapy use. Extrapolating our findings to 3.7 million Australian women aged 40–64 years, we found that 455,000 women are likely to have moderate to severe VMS, with most women (385,000) remaining untreated. Most women with severe menopausal symptoms remain untreated despite the availability of safe non-hormone therapies and safer low-dose transdermal hormone therapies. Vaginal estrogen therapy is underprescribed.
Worsley R, Bell RJ, Gartoulla P, Davis SR. Low use of effective and safe therapies for moderate to severe menopausal symptoms: a cross-sectional community study of Australian women. Menopause. 2015 Jul 31. Epub ahead of print
Content updated 20 September 2015