Perceptions of and attitudes toward estrogen therapy among surgically menopausal women in Taiwan

Abstract

To evaluate awareness of and attitudes toward estrogen therapy (ET) among surgically menopausal women in Taiwan. We performed a retrospective analysis of 188 women who underwent hysterectomy with bilateral oophorectomy before menopause. Responses to a questionnaire included women's thoughts about 20 of the most common menopausal symptoms, whether they used ET, and their attitudes about taking ET. Mean respondent age at surgery was 45.3+/-4.2 (SD) years; 59 women (31.4%) were either current or former users of ET. Vegetarians had a lower rate of ET use (9.5%) than omnivores (34.1%, P=0.0239, chi2 test). By multiple logistic regression, insomnia (P=0.005), palpitations (P=0.024), and cold sweats (P=0.027) were the symptoms most associated with ET use. The prevalence rates of the 20 menopausal symptoms ranged from 48.9% to 85.6%. By factor analysis, the 20 symptoms were grouped into four clusters: psychological, vasomotor, genital, and somatic. Although ET can improve all 20 symptoms, the effect was superior for the vasomotor cluster (P<0.0001, analysis of variance). Of the women, 154 (81.9%) were aware of ET, and their major sources of information about it were health professionals (48.1%) and the mass media (34.4%). Only 49.5% of the women regarded ET as necessary, and 50.4% of the women who had never used ET claimed that they would use it if their doctor could persuade them that its benefits outweighed its risks. Even though ET can significantly improve vasomotor symptoms, surgically menopausal women in Taiwan have a low rate of ET use.