Racial and Ethnic Disparities in Menopausal Hormone Therapy Acceptance [A134

Abstract

INTRODUCTION: There is a paucity of data on race and ethnicity in hormone therapy (HT) acceptance in previous menopause treatment studies. Our primary objective was to examine differences in HT acceptance between self-reported race and ethnic groups. Our secondary objective was to assess patient comorbidities and trends in reported symptom frequency at presentation in a menopause-focused care clinic. METHODS: Retrospective medical record review of patients presenting to a single menopause clinic from July 2018 to July 2021 at a tertiary level, urban, academic center in the Midsouth. Statistical tests included t test and odds ratios, with P values <.05 considered significant. RESULTS: A total of 113 patients presented with menopausal symptoms and were included; 58 (52%) were Black, 47 (42%) were White, and 8 (6%) declined to answer. Of 42 women with vasomotor symptoms, 23 (55%) accepted lifestyle modification therapy and 19 (45%) accepted HT. Of 34 women with vaginal dryness, only 5 (15%) accepted vaginal HT, while 29 (85%) accepted moisturizers/lubricants. A total of 20 patients were excluded from eligibility for systemic HT due to medical comorbidities. Of 37 women eligible for systemic HT, 18 (49%) of White women accepted HT, compared to only 9 (24%) of Black women. This difference was statistically significant (P=.01). Black women were 24% less likely to accept HT for menopausal symptom management (OR, 0.24; 95% CI, 0.09–0.64). CONCLUSION: Our pilot study suggests racial disparity in acceptance of HT among perimenopausal and postmenopausal women. This can inform clinicians about patient factors affecting treatment choice for menopausal symptoms and opportunities to explore racial differences in quality of care.