Study reports substantial decline in Menopausal Hormone Therapy use among US postmenopausal women over past 20 years
Menopausal hormone therapy (MHT) is the preferred treatment for menopausal symptoms, but its acceptance is limited due to weighing the risks and benefits regarding short-term and long-term health outcomes. Recent cross-sectional study evaluated trends in the use of menopausal hormone therapy (MHT) among postmenopausal women in the US from 1999 to 2020. The researchers used data from the nationally representative National Health and Nutrition Examination Survey (NHANES) to examine the prevalence and correlates of MHT use over this time period.
Prevalence Decline in MHT Use
The results showed a significant decline in the prevalence of MHT use among postmenopausal women overall, from 26.9% in 1999-2000 to just 4.7% in 2017-2020. This decline was observed across all age groups, though the greatest decreases were seen among women aged 52 to <65 years.
Differences by Race and Ethnicity
Differences were also found by race and ethnicity. Non-Hispanic White women consistently had the highest prevalence of MHT use, but the prevalence declined from 31.4% in 1999-2000 to 5.8% in 2017-2020. In contrast, non-Hispanic Black women had the lowest prevalence, declining from 11.9% to 0.5% over the study period. Hispanic women and women of other racial/ethnic groups also saw significant decreases in MHT use. In terms of MHT formulations, estrogen-only preparations accounted for the majority (>50%) of MHT use in most study periods. However, there were some fluctuations, with a decrease in progestogen-only and combined estrogen/progestogen formulations after 2001-2002, followed by an increase again after 2007-2008. Multivariable analyses revealed that factors associated with higher MHT use included younger age, non-Hispanic White race, higher family income-to-poverty ratio, and having health insurance coverage, particularly private insurance. Educational attainment was associated with MHT use among non-Hispanic Black and Hispanic women, but not non-Hispanic Whites. Obesity and current smoking were inversely associated with MHT use in non-Hispanic White women.
Study Conclusion
In summary, this study documented a substantial decline in MHT use among US postmenopausal women over the past 20 years, with significant differences by age, race/ethnicity, and other sociodemographic factors. These findings provide important insights to guide discussions and policies around the use of MHT, particularly in light of the continued need to manage menopausal symptoms in women.
Key Points
1. The study evaluated trends in the use of menopausal hormone therapy (MHT) among postmenopausal women in the US from 1999 to 2020.
2. The prevalence of MHT use declined significantly from 26.9% in 1999-2000 to just 4.7% in 2017-2020, with the greatest decreases seen among women aged 52 to <65 years.
3. Non-Hispanic White women had the highest prevalence of MHT use, but it declined from 31.4% to 5.8% over the study period. Non-Hispanic Black women had the lowest prevalence, declining from 11.9% to 0.5%.
4. Estrogen-only preparations accounted for the majority (>50%) of MHT use, with fluctuations in progestogen-only and combined estrogen/progestogen formulations over time.
5. Factors associated with higher MHT use included younger age, non-Hispanic White race, higher family income-to-poverty ratio, and having health insurance coverage, particularly private insurance. Obesity and current smoking were inversely associated with MHT use in non-Hispanic White women.
6. The study documented a substantial decline in MHT use among US postmenopausal women over the past 20 years, with significant differences by age, race/ethnicity, and other sociodemographic factors.
Reference –
Yang L, Toriola AT. Menopausal Hormone Therapy Use Among Postmenopausal Women. JAMA Health Forum. 2024 Sep 6;5(9):e243128. doi: 10.1001/jamahealthforum.2024.3128. PMID: 39331372; PMCID: PMC11437377.
