liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Attitudes towards the menopause and hormone therapy over the turn of the century
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
Show others and affiliations
2007 (English)In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 56, no 1, 12-20 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To assess attitudes and beliefs about the menopausal transition in a population of peri- and postmenopausal women, and if these attitudes differed before and after publication of studies on risks and benefits with hormone therapy (HT).

Material and methods: In 1999 and 2003 all women aged 53 and 54 years in the community of Linköping, Sweden, were sent a questionnaire about use of HT, menopausal status and attitudes regarding menopause and HT.

Results: Most women regarded menopause as a natural process characterized by both hormonal deficiency and aging and these views did not differ between 1999 and 2003. A majority of women thought that significant climacteric symptoms were a good reason to use HT, but not that women without symptoms should use HT. The fraction of women who supported HT use was, however, significantly lower in 2003 than in 1999. Most women agreed that menopause leads to increased freedom and that it is a relief not to have to think about contraception and pregnancies.

Conclusions: Most Swedish women had a mainly biological view on menopause but nevertheless they thought that only women with climacteric symptoms should use HT. Women’s attitudes towards HT have changed after recent reports on risks from long-term use of HT whereas the attitudes towards the menopausal transition were stable. Other factors than attitudes towards menopause affect women’s actual use of HT. Probably women’s and health care provider’s apprehension of the risk-benefit balance of HT use is one such factor.

Place, publisher, year, edition, pages
Institutionen för klinisk och experimentell medicin , 2007. Vol. 56, no 1, 12-20 p.
Keyword [en]
Menopause transition, climacteric, attitudes to menopause, attitudes to hormone therapy, population-based questionnaire
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-11697DOI: 10.1016/j.maturitas.2006.05.002OAI: oai:DiVA.org:liu-11697DiVA: diva2:18120
Note
Original publication: Lotta Lindh-Åstrand, Jan Brynhildsen, Mikael Hoffmann, Susanne Liffner and Mats Hammar, Attitudes towards the menopause and hormone therapy over the turn of the century, 2007, Maturitas, (56), 1, 12-20. http://dx.doi.org/10.1016/j.maturitas.2006.05.002. Copyright: Elsevier B.V., http://www.elsevier.com/Available from: 2008-04-29 Created: 2008-04-29 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Women's knowledge, attitudes, and management of the menopausal transition
Open this publication in new window or tab >>Women's knowledge, attitudes, and management of the menopausal transition
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Hormone therapy (HT) has been considered as a safe treatment for menopausal symptoms. Use of HT increased dramatically in the 1980s and 1990s. Results from large randomized clinical trials (RCT) could, around the turn of the century, however not find evidence for long-term benefits with HT. These results attracted great attention from media and the scientific community leading to changed treatment guidelines and decreased use of HT.

Aim: The overall aim of this thesis was to explore Swedish women’s conceptions, knowledge, management, and attitudes regarding the menopausal transition and HT.

Material and methods: To explore and describe women’s conceptions of the menopausal transition women seeking medical advice due to climacteric symptoms were interviewed (n=20) and their statements were analyzed with a qualitative method (paper I). In 1999 (n=1760) and 2003 (n=1733) attitudes to (paper II) and knowledge of (paper III) the menopausal transition and HT among 53- and 54 year old women were investigated with a cross-sectional design using postal questionnaires. We also analyzed if attitudes differed before and after new scientific findings were published on risks and benefits of HT and if knowledge differed between educational levels. Since many women try to abandon use of HT a RCT was performed to study the effect of two different methods to discontinue HT, on recurrence of hot flushes, resumption of HT and on health related quality of life (HRQoL). Women (n=87) with vasomotor symptoms before initiating HT participated.

Results: We found that the majority of the middle aged women in our study viewed the menopausal transition as a natural process the nature of which is affected by both hormonal changes and by ageing. Each woman seems to experience a set of psychological and physical symptoms that are in some sense unique to her experience. Women’s answers to the questions about HT demonstrate that attitudes towards HT held by women going through menopause have changed rather dramatically between 1999 and 2003. These changes probably reflect the influence on the women of media reports based on research that identified risks associated with HT that had not been identified before 1998.

Women’s knowledge of the effects of HT seems to be unsatisfactory from a clinical perspective. No differences in hot flush frequency and resumption of HT were found between the women randomized to two different modes of discontinuation of HT. Almost 50 % of the women restarted HT within one year after discontinuation. Deteriorated wellbeing and severity of hot flushes were important predicting factors for resumption of HT.

Conclusion: It is important to be aware of the individual woman’s conceptions and attitudes about and knowledge of the menopausal transition and HT to be able to individualize the counselling situation. Women who initiate HT due to hot flushes may experience recurrence of vasomotor symptoms and deteriorated HRQoL after discontinuation. A great proportion of them may resume HT. At present knowledge of possible advantages for the taper-down method when discontinuing HT is still lacking.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 67 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1153
Keyword
Menopause, hormone therapy, knowledge, attitudes, conceptions, management/treatment, climacteric symptoms, hot flushes
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-21896 (URN)978-91-7393-531-9 (ISBN)
Public defence
2009-10-30, Aulan, Hälsans Hus, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2009-10-12 Created: 2009-10-06 Last updated: 2009-10-12Bibliographically approved

Open Access in DiVA

fulltext(86 kB)1018 downloads
File information
File name FULLTEXT01.pdfFile size 86 kBChecksum MD5
2011477815eb84e062955db18421c82be96ea25d469ccd5b2216aad3d076421a98a3b2a9
Type fulltextMimetype application/pdf

Other links

Publisher's full textLink to Ph.D. Thesis

Authority records BETA

Lindh-Åstrand, LottaBrynhildsen, JanHoffmann, MikaelHammar, Mats

Search in DiVA

By author/editor
Lindh-Åstrand, LottaBrynhildsen, JanHoffmann, MikaelHammar, Mats
By organisation
Department of Clinical and Experimental MedicineFaculty of Health SciencesDepartment of Gynecology and Obstetrics in LinköpingObstetrics and gynecology Clinical Pharmacology
In the same journal
Maturitas
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 1018 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 242 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf