Womens attitudes and knowledge about the climacteric period and its treatment. A Swedish population-based study

Objectives: The aim of the study was to investigate womens knowledge and attitudes about the menopause and hormone replacement therapy (HRT). Material and methods: Women aged 46, 50, 54, 58 and 62 years, born on uneven days, resident in Goteborg, Sweden (n = 5.990) were invited by letter to complete a questionnaire concerning the menopause and HRT. Results: The response rate was 76% (n = 4504). Current estrogen use was reported by 21%. Another 20% had stopped estrogen use e.g. because of a fear of cancer (9%) or other side-effects (14%). The most common reasons to refrain from HRT were minor climacteric symptoms (27%), fear of cancer (9%) or side-effects (15%) and the opinion that the menopause is a natural process (20%). A majority (67%) preferred HRT without withdrawal bleedings, especially elderly women (80%). Thirty-five per cent could accept life-long HRT if treatment was free from withdrawal bleedings. Almost 70% received their information about the menopause and HRT from a physician. Forty-five percent of the women considered the menopause to be a relief. Approximately 60% had a regular sex-life. The most common reasons for not having a regular sex-life were irrespective of the womans age, the absence of a partner (43%). Loss of sexual desire (29%) or partners loss of desire (12%), both of which showed an increase with age, were other reasons given. Only 8% of the total population had no sexual activity because of vaginal dryness but in the oldest cohort (62 years old) 32% gave this as a reason. Conclusion: Physicians require more time for counselling of patients about the menopause and HRT. Many women refrain from therapy because of fear and misconceptions. To achieve better long-term compliance epecially in elderly women the use of 'non-bleeding' regimes requires further attention. (C) 1997 Elsevier Science Ireland Ltd.