Article Text
Abstract
Introduction/Background It is well-recognized that premature surgical menopause without subsequent hormone replacement therapy (HRT) is associated with increased morbidity and mortality. Our objective was to describe HRT use in a cohort of women from British Columbia (BC), Canada with premature surgical menopause.
Methodology A population-based retrospective cohort study of women who underwent surgical menopause between ages 19–50, identified from Medical Service Plan Payment Information from BC, and linked to prescription histories from the provincial PharmaNet database from 2004–2014. Women with personal history of cancer were excluded.
Results A total of 11,864 women were included. Median age of surgical menopause was 43 years. Median follow-up duration was 5.5 years (range: 0–10 years). The majority of women did not have a BRCAmutation (99.1%). They underwent bilateral salpingo-oophorectomy (90%) or bilateral oophorectomy (10.4%), and 50.5% had concurrent hysterectomy. There were 196 (1.7%) diagnosed with malignancy. The remainder had benign diagnoses, the most common of which were adnexal masses (17%), endometriosis (17.9%), and abnormal bleeding (14.3%). During the 10-year study period, only 55.4% had ever used HRT. Use of HRT for <6 months, 6–12 months, 1–5 years, and >5 years after surgery were 38.2%, 8.9%, 32.7%, and 20.2%, respectively. Those who did not use HRT had more physician visits for cardiovascular disease (19% vs. 9%) and osteoporosis (13% vs. 9%) compared to ever-users, respectively (p=0.002).
Conclusion In this large population-based study investigating HRT rates following premature surgical menopause, only half of these women ever used HRT, and a greater proportion of those who did not use HRT had physician visits for cardiovascular diseases and osteoporosis. These results underscore a need for education and ongoing follow-up in this patient population.
Disclosure Nothing to disclose.