Psychosocial factors associated with the use of hormonal replacement therapy in a longitudinal follow-up of Swedish women

Objectives: To follow up a cohort of 1400 women aged 52 years who had replied to a health questionnaire 4 years previously. The follow-up covered general and gynecological health, experience of symptoms, the use of hormone replacement, the reasons for starting HRT and effectiveness of treatment as well as comparison of users and nonusers concerning psychosocial factors and life style. Methods: A questionnaire together with a letter was mailed to the women who had responded previously. The questionnaire covered four different areas: sociodemographic background, general and gynecological health, a 20-item symptom rating scale, and questions concerning work role. Results: A total of 1194 women (85%) responded to the questionnaire; 40% of the women were currently using hormone replacement. The reasons for starting treatment were: relief of somatic (55%) and psychological symptoms (20%), increased wellbeing (5%), to prevent disease (5%) and other reasons, such as keeping young (15%). Positive effects were experienced by 86% and negative effects by 26%. Women using HRT had less frequent vasomotor symptoms, sleep problems and vaginal dryness and were more harmonious than nonusers. There were no differences between HRT users and nonusers regarding negative mood and sexual desire. Women with psychologically demanding and stressful jobs requiring concentration were more likely to use hormone replacement. Conclusions: Swedish women are increasingly willing to start hormone replacement, particularly those who suffer from vasomotor symptoms and who have stressful and psychologically demanding occupations. The majority of these experience relief of symptoms. A certain proportion will suffer from side effects and are likely to discontinue treatment. (C) 1997 Elsevier Science Ireland Ltd.