The Menopause Society reports low rates of hormone therapy usage

The Menopause Society reports low rates of hormone therapy usage | Image Credit: © Vitalii Vodolazskyi - © Vitalii Vodolazskyi - stock.adobe.com.

While hormone therapy (HT) has multiple benefits backed by a substantial body of evidence, usage remains low among women in the United States, according to a recent study presented at the 2024 Annual Meeting of The Menopause Society.¹

The Women’s Health Initiative (WHI) initially highlighted the potential health risks of HT use, such as breast cancer and stroke. This led to dramatic shifts in menopause care use because of concerns among patients.

Since publication of the WHI in 2002, many trials have indicated high safety and efficacy from HT for the use against menopause symptoms, allowing for clarity surrounding the risks and benefits. Guidelines have also recommended HT as a first line therapy against night sweats and hot flashes.

Benefits of hormone therapy that have been identified include reduced biological aging, which often has discrepancy when compared to biological aging.² In a recent trial, a history of HT use was linked with 0.17 fewer years of aging discrepancy, with a reduction occurring regardless of socioeconomic status.

Despite these strides, the rate of HT prescriptions has never increased back to levels from before publication of the WHI.¹ Additionally, rates have remained stagnant following steep declines occurring in the immediate aftermath of WHI publication.

Investigators conducted a study to evaluate systemic HT use among women aged at least 40 years from 2007 to 2023. HT use was defined as having at least 180 days of a filled prescription for systemic estrogen-containing menopausal HT within 1 year.

Rates of HT use were assessed across age groups, with these groups including 40 to 44 years, 45 to 49 years, 50 to 54 years, 55 to 59 years, 60 to 64 years, 65 to 69 years, and 70 years or more. HT use was also assessed based on oral vs transdermal estrogen.

The study population significantly increase over time, from approximately 2 million in 2007 to 4.5 million in 2024. This was caused by a record high number of women entering menopause during this period.

In 2007, a rate of 4.6% was reported for HT use in women aged at least 40 years. Between 2007 and 2014, this rate decreased to 2.5%, with a further decrease to 1.8% reported by 2023. Among users of HT, oral HT was used most frequently.

HT use was reported in 3.2% of women aged 45 to 49 years in 2007, 6% of those aged 50 to 54 years, and 7.3% of those aged 55 to 59 years. By 2023, these rates decreased to 1.5%, 3.6%, and 3.8%, respectively.

Stephanie Faubion, MD, MBA, medical director for The Menopause Society noted that HT use has not increased in the 2 decades since results of the WHI were published, with usage rates remaining under 4%. These low rates were even reported in women aged under 60 years with increased symptoms.

“These findings suggest that substantial barriers to HT use remain, and additional efforts are needed to educate women and clinicians about menopause management and HT use more specifically," Faubion said.

Additional study details were reported at the 2024 Annual Meeting of The Menopause Society, during the presentation, "Menopausal Hormone Therapy Utilization (2007-2023) Remains Stagnant in the United States."

References

1. Hormone therapy usage rates still low despite proven benefits. The Menopause Society. September 10, 2024. Accessed September 12, 2024.
2. Krewson C. Hormone therapy linked to reduced biological aging. Contemporary OB/GYN. August 30, 2024. Accessed September 12, 2024. https://www.contemporaryobgyn.net/view/hormone-therapy-linked-to-reduced-biological-aging