Climacteric symptoms more severe in 2010 than in 2000 - experience of Finnish women aged 52-56 years not now or previously on menopausal hormone therapy.

OBJECTIVES: To analyze and compare the experience of climacteric symptoms and their associations with sociodemographic and health-related characteristics in two cohorts of Finnish women aged 52-56 years, born ten years apart and not now or previously on menopausal hormone therapy (MHT). STUDY DESIGN: Nationwide population-based time-trend study with a large number of participants (n = 1986 + 1988). MAIN OUTCOME MEASURES: The experience of climacteric symptoms was assessed by 12 commonly used menopause-related symptoms. RESULTS: Women aged 52-56 experienced more moderate or severe symptoms and fewer mild symptoms in 2010 than in 2000. Being unemployed or inactive was associated with more severe symptoms (P = 0.007), but employment status had no effect on the relative odds estimates. CONCLUSIONS: The influence of the birth cohort and time-period effects as well as work-related factors on the experience of climacteric symptoms in women not now or previously on MHT needs further research, particularly since the change in the experience of symptoms found in this study occurred within only ten years.

Psychological behavior patterns and coping with menopausal symptoms among users and non-users of hormone replacement therapy in Finnish cohorts of women aged 52-56 years.

OBJECTIVE: To identify subgroups of women who differ with respect to self-evaluated stress, hostility, optimism and sense of coherence, and to identify differences, if any, in whether these subgroups use or do not use hormone replacement therapy (HT). STUDY DESIGN AND METHODS: This time-trend study is based on the Finnish national HeSSup study, in which nationwide cohorts of Finnish women aged 52-56 years randomly selected in 2000 (n = 1321) and in 2010 (n = 1389) responded to postal questionnaires related to four psychological behavior patterns. MAIN OUTCOME MEASURES: Relationships between psychological behavior patterns (stress, hostility, optimism and sense of coherence) and how menopausal symptoms are experienced and how this relates to the use of HT. RESULTS: The proportion of HT users was higher among those with more stress and hostility and less optimism and sense of coherence than among those low in stress and hostility and high in optimism and sense of coherence. CONCLUSIONS: Differences in psychological behavior patterns influence the perception of menopausal symptoms and the use of HT. When the treatment of women at menopause is planned, psychological behavior patterns should be considered, as these reflect the ability to cope with menopausal symptoms.

Change in the frequency of HRT use from 2000 to 2005 and reasons to discontinue: follow-up of a normal cohort in Finland.

OBJECTIVE: To examine frequencies of the use of hormone replacement therapy (HRT) in a follow-up cohort of women aged 57-61 years in 2005 and to discover reasons why the women who used HRT in 2000 discontinued it. DESIGN: Questionnaire survey. SETTING: Five-year cross-sectional follow-up study. SAMPLE: Cohort of 52- to 56-year-old Finnish women. METHODS: Single- and multi-predictor model analyses. MAIN OUTCOME MEASURES: Frequency of HRT users and quitters and reasons behind the discontinuation. RESULTS: Altogether, 35.9% of the women aged 57-61 years used HRT in 2005. Main reasons for the initial use of HRT among users and among those who discontinued included the perceived experience of severe climacteric symptoms as well as maintenance of health and prevention of mostly cardiovascular diseases. Main reasons to discontinue HRT included desire to stay without medication, side-effects, reaction to recent controversial findings in 'HRT publications' and fear of cancer. Those women who used but discontinued HRT had used it for less time than those who continued. Women who discontinued were older and initially started using HRT to maintain health. Neither the severity of climacteric symptoms nor reporting on positive or negative effects prior to starting use had influence on the women's discontinuance of HRT. CONCLUSIONS: The use of HRT was still frequent in Finland in 2005 despite the impact of controversial research results from the early 2000s. For those who discontinued HRT, these reports played an important role.

Treatment of climacteric symptoms in Finland prior to the controversial reports on hormone therapy.

OBJECTIVE: To examine the use of hormone therapy (HT) or alternative treatments for climacteric symptoms among women aged 52-56 years in 2000. DESIGN: Questionnaire study. SETTING: Cross-sectional Finnish female cohort in the year 2000. SAMPLE: Random sample of women aged 52-56 years. METHODS: Univariate and multivariate analysis. MAIN OUTCOME MEASURES: HT explained by 12 physical and 9 background and social variables. RESULTS: The use of HT was significantly (p<0.001) associated with the severity of climacteric symptoms, a history of not having breast cancer, oophorectomy, low body mass index, high professional education and high alcohol intake. A total of 66% of the women used some form of treatment for their climacteric symptoms. Of them, 71% used systemic HT, 25% alternative treatments (hypnotics, antidepressants, tranquillizers\, trace elements, vitamins, lifestyle modifications) and 4% local estrogens only. Altogether 33% of the women with severe climacteric symptoms did not use HT at all, whereas 27% without any symptoms used HT. CONCLUSIONS: In early 2000, almost half of the Finnish female population at menopause used HT to alleviate their climacteric symptoms. The impact of the controversial reports on HT use after the time of data collection needs further study.