Use of hormone therapy for menopause remains low in US - despite proven benefits
New study from The Menopause Society confirms hormone therapy usage rates have declined and remain low
Hormone therapy (HT) use in women over 40 has declined from 4.6% in 2007 to a low of just 1.8% as of 2023.
This is despite a record increase in the number of women entering the menopause transition, pushing the study population from roughly 2 million in 2007 to 4.5 million in 2023.
Dr Stephanie Faubion, medical director for The Menopause Society (formerly the North American Menopause Society) and lead author of the HR utilisation study said:
“This study provides new data on HT utilization rates in the US. Unfortunately, we have not seen HT use increase in the two decades since the publication of the WHI trial results.
“In fact, usage rates remain under 4%, even in women under the age of 60 years who are typically the most symptomatic. These findings suggest that substantial barriers to HT use remain, and additional efforts are needed to educate women and clinicians about menopause management and HT use more specifically.”
Hormone therapy history
The risks and benefits of hormone therapy (HT) have been rigorously debated for more than two decades since the now infamous Women’s Health Initiative (WHI) results of 2002 which were published and appeared to show potential health risks.
Despite substantial evidence since then confirming the safety of HT, the new study out this week confirms that usage has remained stagnant in the US.
There has been regular and ongoing clarification of the risks and benefits of HT as well as guidelines recommending it as first line therapy for hot flashes and night sweats. Yet the number of prescriptions written for HT has never rebounded to pre-WHI levels and, in fact, has remained stagnant after steep declines immediately following the release of the WHI results.
Use of hormone therapy
The latest study has looked at:
systemic menopausal HT utilisation in women aged 40 and older between 2007 and 2023 (with the rate of HT utilisation defined as the proportion of women in a year who had at least 180 days of a filled prescription for systemic estrogen-containing menopausal HT).
age groups (40-44; 45-49; 50-54; 55-59; 60-64; 65-69; and 70+ years).
oral versus transdermal estrogen as a way of classifying systemic HT.
The results show that:
HT use in women aged 40 or older—the same women most likely to suffer from bothersome menopause symptoms—was 4.6% in 2007, then decreased to 2.5% between 2007 and 2014, and continued to decline to 1.8% in 2023. Oral HT was the most common route of administration.
Among women aged 45-49, 50-54, and 55-59 (within 10 years of the mean age of menopause), HT use decreased from 3.2%, 6% and 7.3% in 2007 to 1.5%, 3.6% and 3.8% in 2023, respectively.
Full results of the study will be presented at the 2024 Annual Meeting of The Menopause Society in Chicago this week (10-14 September).