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York research shows Canadian women opting out of hormone therapy

Canadian women using hormone therapy (HT) treatments to manage the symptoms of menopause are recorded in declining numbers, according to a new study out of York University's Faculty of Health.

Christy Costanian

Christy Costanian

Christy Costanian, a fourth-year PhD candidate in the School of Kinesiology and Health Science (epidemiology), published a paper in Menopause, the journal of The North American Menopause Society, that shows a continued decline in HT.

Costanian documents the decline, along with the factors affecting a Canadian woman’s likelihood of using HT that include age, education, ethnic background and a variety of risk factors.

"The overall aim of my dissertation research is to investigate the various life course factors related to hormone therapy (HT) use and to an earlier menopause using secondary data analysis," said Costanian. "Using the Canadian Longitudinal Study on Aging (CLSA) platform, this study aimed to elucidate factors associated with hormone therapy use among women."

The article “Hormone therapy use in the Canadian Longitudinal Study on Aging: a cross-sectional analysis” reports that 9.5 per cent of the sample reported current use of HT, whereas 21.9 per cent reported past use.

Baseline data from the tracking cohort of the CLSA was used for this analysis. The main outcome was HT use among women aged 45 to 85 years, defined as current, past, and never users. Multinomial logistic regression models were used to examine the differences between current, past, and never HT users in terms of sociodemographic, health behavior, and health-related variables.

The main factors associated with a lower likelihood of current HT use were older age (greater than 80 years old), nonwhite ethnic background, current employment, regular smoking, obesity, and breast cancer. By contrast, alcohol consumption, and the presence of allergies or mood disorders, were positively associated with current HT use.

The findings provide a recent national picture of HT use in Canada that may be used to inform opportunities for improved physician-patient communication regarding menopause management.

"The results of this study help clarify the extent to which individual socio-demographic, health related, and behavioral characteristics are associated with the use of HT, said Costanian. "Our results might help reveal ways of improving women’s decision-making regarding HT by highlighting those who are not using HT who perhaps should be using it."

The safety of hormone therapy for most women young than age 60 or within 10 years of menopause onset has been recently affirmed by The North American Menopause Society, according to JoAnn Pinkerton, NAMS executive director.