Women's reasons for using postmenopausal hormone replacement therapy: Preventive medicine or therapeutic aid?

The challenge to raise women's consciousness of the cardioprotective benefits of hormone replacement therapy (HRT) has received increasing attention, as heart disease is the primary cause of mortality of postmenopausal women in America. This study aimed (1) to ascertain whether, and to what extent, prevention of cardiovascular disease (CVD) and osteoporosis figures in women's reasons for taking postmenopausal HRT and (2) to assess relationships between women's reasons for taking HRT and various demographic and CVD risk factors. A convenience sample of 91 women (73 White, 18 Black) completed a personal interview and a 24-page survey. Eighty-two women (90%) were current or former users of HRT. Reasons were categorized as Preventive - to prevent heart disease and/or osteoporosis (n = 45) - or as Therapeutic - to alleviate or control hot flashes or other symptoms (n = 50). Twenty-nine women gave both Preventive and Therapeutic reasons. Women gave reasons relating to the prevention of osteoporosis (n = 40) more frequently than reasons relating to the prevention of heart disease (n = 24) as being salient to their utilization of HRT. Thus, the heart disease preventive value of HRT seems to be underappreciated in this group. More striking, nearly 20% of this generally well-educated group (62% college graduates) reported no specific health reason for HRT but only that "the doctor recommended it" or that they took HRT solely on "the doctor's advice" (n = 16). Results suggest that a more far-reaching educational message about CVD risk prevention might foster greater awareness among women of the cardioprotective benefits of HRT.