Social and behavioural influences on the uptake of hormone replacement therapy among younger women
Social and behavioural influences on the uptake of hormone replacement therapy among younger women
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DOI：
10.1111/j.1471-0528.2000.tb13333.x
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发表时间：
2000-06-01
期刊：
影响因子：
--
通讯作者：
Wadsworth, M
中科院分区：
文献类型：
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作者：
Kuh, D;Hardy, R;Wadsworth, M
目的描述社会和行为对50岁以前接受激素替代治疗的影响。设计具有全国代表性的出生队列研究，包括详细的激素替代治疗史和前瞻性数据，收集整个生命周期中的心脏，社会和行为因素。苏格兰和威尔士人口1572名妇女的一般人口样本，随访至50岁。主要结果测量首次使用激素替代疗法的年龄。45%的女性曾尝试过激素替代疗法，三分之一的女性目前正在使用激素替代疗法。超过五分之二的用户尝试过不止一种制剂，超过四分之一的用户偶尔使用过。对于绝大多数人来说，处方符合现行指南。与受教育程度较低的同龄人相比，更多受教育的妇女采取激素替代疗法进行长期预防。子宫切除术增加了接受激素替代疗法的机会，特别是在还进行了卵巢切除术的情况下，并且与更长时间和更连续的使用有关。考克斯比例风险模型的结果表明，首次使用激素替代疗法的妇女谁没有子宫切除术的年龄是受以前的月经失调，以前使用口服避孕药和香烟，过去的健康问题和低社会阶层的报告与卫生服务接触。吸烟和低社会阶层与早期使用激素替代疗法之间的关系可能是由于他们与早期menopause.Conclusions的趋势在过去的二十年中更大的使用激素替代疗法的年轻女性继续有增无减。到目前为止，这一代激素替代疗法使用者的健康生活方式和社会优势不如非使用者，这与许多基于前几代人的旧研究（主要是美国研究）相反。随着战后婴儿潮一代的老龄化，这可能对健康和医疗保健产生长期影响。
Objective To describe the social and behavioural influences on the uptake of hormone replacement therapy before the age of 50.Design Nationally representative birth cohort study with detailed hormone replacement therapy histories and prospective data on hearth, social and behavioural factors collected throughout Life.Setting England, Scotland and Wales.Population General population sample of 1572 women followed to the age of 50 years.Main outcome measure Age at first hormone replacement therapy useResults By the age of 50 years, 45% of women had tried hormone replacement therapy and one third were current users. Over two-fifths of users had tried more than one preparation and over one quarter had episodic use. For the vast majority, prescribing conformed to current guidelines. More educated women took hormone replacement therapy for long term prevention compared with their less educated peers. Hysterectomy increased the chances of taking hormone replacement therapy, particularly where an oophorectomy had also been performed, and was associated with longer and more continuous use. Results of a Cox's proportional hazards model showed that the age at which first hormone replacement therapy is used by women who have not had a hysterectomy was influenced by previous contact with health services for menstrual disorders, previous use of oral contraception and cigarettes, past reporting of health problems and low social class. The relation between smoking and low social class with early use of hormone replacement therapy may be due to their association with early menopause.Conclusions The trend over the last two decades towards greater use of hormone replacement therapy has continued unabated for younger women. So far, hormone replacement therapy users in this generation have had less healthy lifestyles and social advantages than nonusers, in contrast to many older mainly American studies based on earlier generations. This may have long term implications for health and health care as the postwar baby boom generation ages.