Survey Shows Women Need To Know More About Estrogen Therapy

November 02, 1998

CHAMPAIGN, Ill. -- Many menopausal and post-menopausal women are not getting all the information they need or want on estrogen-replacement therapy, according to a study by a University of Illinois researcher.

As a result, they may be missing out on potential benefits from taking estrogen, like a lower risk of heart disease and osteoporosis, says Teresa Gallagher, a professor of community health. Or, in some cases, they could be taking estrogen without knowing some of the risks.

Gallagher led a survey of 1,469 women between ages 40 and 69 who were members of a Connecticut HMO, looking to determine the extent to which they were being counseled about estrogen replacement, as called for in various national clinical guidelines. A total of 1,004 (or 69 percent) of those women responded to a mail survey, with 693 saying they were either going through or were past menopause.

Among those 693 respondents, 69 percent said they had received at least some level of counseling about estrogen-replacement therapy by a doctor or health-care provider, Gallagher said. But only 40 percent said they had enough information and advice about their choices, and only 53 percent felt they had made an informed decision about whether or not to take the hormone.

Gallagher also noted that women in the group of 693 who did not consult a health-care provider about menopausal symptoms, for which estrogen replacement is often prescribed, were much less likely to get any counseling -- only 56 percent, versus 82 percent for those who did report symptoms. Only 60 percent of the group said a doctor had talked to them about osteoporosis, and only 54 percent about heart disease, compared with 71 percent who had been advised about breast cancer, she said.

Since the women were drawn from an HMO that has been recognized for its service to patients, Gallagher suggested that the figures for the general population may be lower.

The survey findings were presented in September at the annual meeting of the North American Menopause Society, held in Toronto. Working with Gallagher on the study, funded by Eli Lilly & Co., were Florence Comite and Jennifer FitzGibbons, with the Yale University School of Medicine, and John Aforismo and Juvene Grant, with M.D. Health Plan, the HMO where the study was conducted.

Not all women going through or past menopause should be taking estrogen, Gallagher said, but many may be too focused on a suggested link between estrogen and breast cancer, while ignoring the potential benefits from estrogen. "Women believe that they're much more likely to die of breast cancer than of heart disease, and that's wrong and many women don't understand what osteoporosis is, don't know how much of a threat it is to their health."

Women, in considering estrogen, may not have a "sense of the overall picture," Gallagher said. "It is a very difficult decision, and so it has to be kind of individualized you need to go through this process of going over your risk factors and really talking about the issues."
-end-


University of Illinois at Urbana-Champaign

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