Characteristics associated with initiation of hormone replacement therapy among Finnish women: A register-linkage study

• Most important factors that predicted whether a woman would start HRT were: living with a partner, weak SOC, BMI under 30 kg/m2 and heavy alcohol use.
• Women with a good sense of coherence can cope with climacteric symptoms without resorting to hormone replacement therapy.
• Clinicians need to bear in mind the burden of the menopause on a woman’s personal and working life when hormone replacement therapy is being considered.

ObjectiveTo investigate which patient characteristics are associated with the initiation of hormone replacement therapy (HRT) in a cohort of Finnish women.Study designResponses to postal questionnaires distributed to a nationwide, randomly selected cohort of women in 1998, 2000, 2003, 2005 and 2010 were analyzed. The cohort members were aged 40–44 years at the beginning of the study. Information on hormone replacement therapy was received from the national prescription register. Women who started taking HRT between January 1, 1999 and December 31, 2011 were included and previous users were excluded from the analysis.Main outcome measuresInitiation of HRT was the main outcome measure. The following explanatory factors for predicting the use of HRT were examined: sociodemographic factors, personality, health behavior, physiological and mental symptoms, chronic diseases and use of psychopharmaceuticals. The associations between starting HRT and the explanatory factors were analyzed with single-predictor and multi-predictor logistic regression models.ResultsFactors predicting that a woman would start taking HRT were: living with a partner, weak sense of coherence, BMI less than 30 kg/m2, heavy or moderate alcohol use, symptoms of hyperactivity of the sympathetic nervous system, climacteric symptoms and use of psychopharmaceuticals.ConclusionsWomen with a good sense of coherence can cope with climacteric symptoms without resorting to HRT. Clinicians need to bear in mind the burden of menopausal symptoms on a woman’s personal and working life when HRT is being considered.