Hormone replacement therapy in women with diabetes mellitus: A survey of knowledge of risks and benefits

Abstract

AbstractWomen considering postmenopausal hormone replacement therapy (HRT) require an adequate knowledge base to make an informed choice. To assess knowledge and beliefs about HRT we surveyed 200 consecutive diabetic women in our clinic; 182 completed questionnaires were returned. The age range of respondents was 22–90 years (median 58 years). One hundred and thirty women said they were perimenopausal or menopausal (71%) and 25 were on HRT (19%). Respondents were analysed by age: premenopausal <45; perimenopausal 45–65 and postmenopausal >65 years. Sixty five per cent had heard of HRT and 31% of these thought their knowledge adequate. Significantly fewer older women had heard of HRT.Those with knowledge of HRT were asked to respond to statements concerning risks and benefits and, overall, 49% answered at least one question. There was a clear age‐related trend with significantly fewer postmenopausal women answering any questions. Overall, 35% of respondents thought HRT was safe in diabetes; 15% thought that it could improve diabetes control; 27% thought it improved cholesterol levels; 76% thought it could reduce the risk of brittle bones; 11% thought it had an adverse effect on blood pressure; 48% thought it might decrease the risk of heart disease; and 37% thought that HRT increased cancer risk. Consistent trends suggested that perception of risk was higher and perception of benefit lower with increasing age.Our survey, in a patient group regularly receiving health promotion advice and in whom the impetus for HRT is greater, reveals a poor awareness of HRT a perception of inadequate information and a perception that HRT is not safe in diabetic women.