Significant fall in hormone replacement therapy prescription in general practice.

BACKGROUND: Hormone replacement therapy (HRT) in the past has been used in one of five women but not without significant short-term and long-term consequences. Objective. The aim of the study is to assess the prescription of HRT in general practice to women consulting with menopausal symptoms, before and after publication of the Women's Health Initiative (WHI) study (2002), the Million Women Study and the Lancet Editorial (2003), and to correlate these with co-morbidity, co-medication and frequency of GP consultation. Methods. The study was performed using data collected by a Dutch Continuous Morbidity Registration. We selected women who presented with menopausal symptoms for the first time during the period 1999-2007 (n=341). Women who were prescribed HRT between 2002 and 2007 were compared with women presenting with menopausal symptoms without HRT prescription and women who did not consult for menopausal symptoms. Both control groups were matched for age, socio-economic status and general practice. Results. HRT prescription decreased considerably: from 37% in all women who present with menopausal symptoms at the GP 2002 to 14% in 2003 and 4% in 2004. Women who consulted for menopausal symptoms, irrespective of HRT prescription, presented with nervous functional complaints more often, were prescribed more tranquillizers and visited the GP more frequently than women who did not consult for menopausal symptoms. Conclusions. These GPs were very quick to implement new recommendations on HRT prescription. The decision to prescribe HRT was not correlated with specific emotional or psychiatric problems of the menopausal women.