Use of hormones in the menopausal transition period in the Netherlands between 1993 and 1997

ObjectivesTo describe the patterns and to assess the indicators of hormone use during the menopausal transition period in a Dutch population.MethodsBetween 1993 and 1997, 17,357 women aged 49–70 years participated in the Prospect-EPIC (European Prospective Investigation into Cancer and Nutrition) cohort and filled out an extensive questionnaire, which included information about hormone use during menopausal transition and other medical and lifestyle characteristics. Patterns of hormone use were described and various characteristics were evaluated as indicators of current hormone use by logistic regression.ResultsOverall, 13% of women were current hormone users, which was highest in the 49–54 age group (19%). Hysterectomized women and older non-hysterectomized women mainly used unopposed estrogen therapy (ET), whereas younger non-hysterectomized women mainly used oral contraceptives or combined estrogen + progestogen therapy. Of all ever users, 61% used hormones for more than 1 year and 28% for more than 5 years.The most important indicators of hormone use for women without a surgical menopause were age, alcohol use, smoking, parity, ever use of oral contraceptives and family history of breast cancer. For women with a surgical menopause age, parity, ever use of oral contraceptives, diastolic blood pressure and the number of removed ovaries were the most relevant indicators.ConclusionsThe frequency of hormone use during menopausal transition in the Netherlands is low compared to other western countries, but the duration of use is quite long. Hormone use seems to be largely determined by factors that are known to affect endogenous estrogen levels.