The promotion of menopausal hormone therapy might be determined by the attitude of health-care professionals

Knowledge and attitudes of premenopausal women in southern China toward menopause and menopausal hormone therapy

OBJECTIVE

Menopause is a significant and natural phase in a woman's life, representing a transition that requires early understanding to manage its effects and promote overall well-being. This study aimed to evaluate the awareness, understanding and perceptions of menopause and menopausal hormone therapy (MHT) among premenopausal women in southern China.

METHODS

A cross-sectional design was employed to enroll women aged 18-40 years (n = 1631) from August 2022 to January 2023 at a public hospital in Fujian, China. A structured questionnaire, developed from existing research and the Climacteric Scale, was used to assess women's menopausal symptoms and MHT knowledge. Face-to-face interviews were conducted to identify factors correlated with menopausal knowledge levels.

RESULTS

More than 50% of women demonstrated a comprehensive understanding of menopause. Education level was a significant predictor of menopause knowledge (p < 0.001), with women holding higher education (college degree or above) demonstrating greater knowledge than those with lower education (high school or below). High awareness of common menopausal symptoms, including irritability, sleep disturbances, fatigue, difficulty concentrating and hot flashes, was observed. Although most participants lacked detailed knowledge of MHT, they agreed on the importance of managing menopausal symptoms and recognized the usefulness of MHT for symptom management.

CONCLUSIONS

Premenopausal women in southern China possess a basic understanding of menopause but lack sufficient knowledge about MHT. This highlights the need for educational initiatives and targeted counseling to increase awareness of menopause and MHT, especially regarding its implications and treatment options.

Real-world evaluation of treatment utilization by women experiencing vasomotor symptoms associated with menopause in the United States and Europe: Findings from the REALISE study

OBJECTIVES

Despite the profound impact of menopausal symptoms on women, treatment utilization is low, and many seek alternative therapies. The REALISE study aimed to evaluate the treatment landscape - that is, pharmacological treatment, lifestyle changes (LC), and use of over-the-counter (OTC) products - for women from six high-income countries experiencing vasomotor symptoms (VMS) and receiving healthcare.

STUDY DESIGN

Analysis of a secondary dataset, the Adelphi Real World Disease Specific Programme™, a large, cross-sectional, point-in-time survey conducted in the United States and five European countries (February-October 2020). Physicians provided demographic, clinical, and treatment data; women were stratified by VMS severity (mild; moderate-severe) and presence of concomitant sleep/mood symptoms. Women completed forms on VMS severity, concomitant symptoms, LC, and OTC product use. Two subgroups were identified: VMS-only and VMS + sleep/mood.

MAIN OUTCOME MEASURES

Prescription treatment, LC, and OTC product utilization.

RESULTS

Physicians (n = 233) provided data on 1767 women; 825 (46.7 %) completed a self-completion form. Physicians rated 60 % of women with moderate-severe VMS, of whom 709 (66.8 %) were currently prescribed pharmacological treatment; 27.1 % had never been prescribed. Hormone therapy was most frequently prescribed in the moderate-severe group (overall, 49.8 %; VMS-only, 57.4 %; VMS + sleep/mood, 47.3 %), followed by serotonergic antidepressants (15.7 %; 9.7 %; 17.6 %, respectively). Most women (78.3 %) with moderate-severe VMS adopted LC, and 57.6 % used at least one OTC product for VMS relief.

CONCLUSIONS

Nearly a third of women with moderate-severe VMS had never received treatment despite access to healthcare. This, combined with the prevalent use of LC/OTC products, suggests an unmet need for new treatment options to manage VMS and concomitant sleep/mood symptoms.

Menopausal symptoms and attitudes toward hormone replacement therapy among Israeli women

Menopause occurs around midlife and is an inevitable component of women's aging. The study aimed to investigate the associations between the lifetime prevalence of menopausal symptoms and health-related characteristics among Israeli postmenopausal women aged 55-75 years. Additionally, this study aimed to estimate the use of hormone replacement therapy (HRT) and women's attitudes toward this treatment. Data for this study were extracted from a cross-sectional national telephone survey conducted in Israel between 2018 and 2020. For the current study, only postmenopausal women aged 55-75 years were included. Multivariate analyses were used to identify demographic and health-related characteristics associated with menopausal symptoms. The study included 688 participants. Most (68.8%) reported one or more menopausal symptoms, specifically vasomotor symptoms (50.4%). According to the multivariate logistic regression analysis, menopausal symptoms were associated with moderate-high anxiety and/or depression symptoms (OR = 2.01, 95% CI 1.12-3.58) and with osteoporosis (OR = 1.78, 95% CI 1.08-2.92). Although most (78.3%) symptomatic women were bothered by their symptoms, 29.1% received any treatment for symptom relief and only 12.6% reported current or past use of HRT. The findings show that menopausal symptoms were associated with a higher prevalence of anxiety and/or depression symptoms and osteoporosis in the years following menopause. Most symptomatic women did not receive any treatment and the majority were against HRT. Knowledge and awareness about menopause and treatment options should be increased among Israeli women. Additionally, the promotion of positive attitudes toward menopause and HRT use among women and healthcare providers is strongly recommended.

Health-Seeking Behaviors and Treatments Received for Menopause Symptoms: A Questionnaire Survey among Midlife Women Attending Primary Healthcare Clinics in Malaysia

OBJECTIVES

This study aimed to assess menopause symptoms, treatment-seeking behaviors, treatments received, and factors associated with seeking consultation from healthcare providers (HCPs).

METHODS

Using a self-administered Menopause Quick-6 in the Malay language (MQ6[M]) questionnaire, we surveyed 349 women aged 40-60 years attending primary healthcare clinics in four states in Malaysia for their menopause symptoms. Health-seeking behaviors for menopause symptoms were assessed using questions regarding HCPs consulted and treatments prescribed. Binary logistic regression was employed on factors associated with seeking consultation for menopause symptoms.

RESULTS

Using MQ6(M), we observed that 125 (31.3%) women reported at least one menopause symptom, with joint pains (42.8%), menstrual changes (39.5%), and hot flashes (29.3%) being the most frequent symptoms. Furthermore, 60% of the women were prescribed vitamins, and only 13% were administered Hormone Replacement Therapy (HRT). Medical comorbidities, the presence of at least one gynecological condition, menopause status, and MQ6(M) score were associated with seeking consultation with an HCP. For women with medical conditions, the odds of seeking consultation increased by a factor of 1.34 (adjusted odds ratio [AOR], 1.34; 95% confidence interval [CI], 1.11-1.76) for every additional comorbidity. The odds of seeking consultation from an HCP increased by a factor of 1.26 (AOR, 1.26; 95% CI, 1.04-1.47) with a unit increase in MQ6(M) score.

CONCLUSIONS

Most women had menopause symptoms but favored the use of complementary and alternative medicine over HRT. Screening and awareness of menopause treatments need to be improved at primary healthcare clinics.

Prevalence of menopausal symptoms and attitudes towards menopausal hormone therapy in women aged 40-60 years: a cross-sectional study

BACKGROUND

Menopause is a specific physical and psychological transition period for women, during which they experience a series of menopausal symptoms. Menopausal hormone therapy is an important treatment for improving menopausal symptoms. Helping women correctly understand menopausal hormone therapy is a prerequisite for increasing the acceptance and utilization of menopausal hormone therapy by women. Physical examinations are an important method for women to master their own health status and detect potential health problems, and in recent years, an increasing number of women have actively participated in physical examinations. Therefore, this study aims to comprehend the prevalence of menopausal symptoms and attitudes towards menopausal hormone therapy among women aged 40-60 who underwent physical examinations, which would provide a useful reference to reduce the prevalence of menopausal symptoms and improve acceptance of menopausal hormone therapy.

METHODS

This cross-sectional study was conducted at the Health Management Centre of the Affiliated Hospital of Southwest Medical University in Luzhou City, Sichuan Province. The data were collected from 295 women aged between 40 and 60 using convenience sampling. Information on all participants was collected through face-to-face interviews. Participants completed a demographic questionnaire and an attitude towards menopausal hormone therapy questionnaire, and the modified Kupperman index was used to assess the prevalence and severity of participants' menopausal symptoms. The collected data were processed using SPSS and Excel software and analysed using descriptive statistics and logistic regression.

RESULTS

The top 5 menopausal symptoms were insomnia, fatigue, bone and joint pain, sexual dysfunction and emotional instability. Multiple linear regression analysis showed that residence, sexual intercourse frequency, mentality, and physical exercise were the influencing factors of menopausal symptoms. The study showed that 77% of women said they were still reluctant to receive menopausal hormone therapy after experiencing menopause-related symptoms. The main source of menopausal hormone therapy-related knowledge among women was from surrounding menopausal women (62%), and 54% wanted to gain menopausal hormone therapy-related knowledge through a web-based approach.

CONCLUSION

The incidence of menopausal symptoms is higher in women aged 40-60 years, which is related to women's mentality, exercise, and sexual intercourse frequency. In addition, the results of this study indicate that women's knowledge of menopausal hormone therapy is insufficient, which suggests that we need to strengthen health education to improve the acceptance rate of menopausal hormone therapy.