Attitudes to the prescription of menopause hormone therapy for vasomotor symptoms and osteoporosis for patients of different ages: A survey of gynecologists in Belgium.

Introduction: The interpretation of the literature on menopause hormone therapy (MHT) has evolved enormously over the last decade. In recent years, guidelines have reinstated the place of MHT.

Aim: This survey analyzes the prescription (initiation and maintenance) of MHT in relation to patient age and therapy indications.

Material And Method: Two vignettes were sent to gynecologists working in Belgium in a random survey. One vignette concerned the initiation of therapy for a woman who was either 52 or 62 years old, suffering either from severe vasomotor symptoms (VSM) or from osteoporosis. The second vignette concerned the maintenance of MHT or switching to another medication in a woman aged 62 years who suffered either from VSM (when stopping MHT) or from osteoporosis. The physicians were asked how they would treat these two patients.

Results: We analyzed 443 vignettes from 222 physicians.

Initiation Of Mht: 84% of the respondents would initiate MHT for a 52-year-old woman with VMS, whereas only 32% would do so for a 52-year-old woman who had osteoporosis (chi square = 33; p < 0.001). 51% would initiate MHT for a 62-year-old woman with VMS, whereas only 14% would do so for a 62-year-old woman with osteoporosis (chi square = 17; p < 0.001).

Maintenance Of Therapy: 87% would maintain MHT for a 62-year-old woman with severe VMS and 52% would do so for a 62-year-old woman with osteoporosis (Chi Square 31; p < 0.001).

Conclusion: VMS are recognized as an indication for MHT, but osteoporosis much less so, even for women around the age of 50.