Physicians' judgments about estrogen replacement therapy for menopausal women.

A study was undertaken to determine how physicians decide when to prescribe estrogen. Twenty-five gynecologists and 25 family physicians responded to case histories and a questionnaire regarding estrogen administration. There was no difference in mean probability of prescribing, 0.42 for gynecologists and 0.40 for family physicians. Endometrial cancer risk and vasomotor symptom severity were significant factors in prescribing judgments; osteoporosis risk and current treatment status were not. In linear regression analysis the constant, not factor weights, were significantly related to each physician's overall likelihood of prescribing and to the individual's self-characterization as prescriber or nonprescriber. Most physicians indicated that estrogen reduces fracture risk, and that progestin reduces cancer risk. Physicians' responses to cases were not consistent with these stated beliefs about estrogen effects.