Health & Medical Menopause health

A Decade of Postmenopausal HT Prescribing in the US

A Decade of Postmenopausal HT Prescribing in the US


The yearly study population varied from a low of 3,579,838 in 2000 to a high of 9,712,325 in 2009. The change in eligible women over time was primarily caused by increases in the sample populations for which data were available. The mean age of the study populations remained similar across the 10-year period ( Table 1 ).

Overall HT Use

The prevalence of women using HT in each year’s study population declined from 21.6% in 2000 to 8.8% in 2009. This decline was seen in all age groups ( Table 1 ). Incidence declined between 2001 and 2003 (5.6% to 3.1%) and then remained relatively stable through 2009 (Fig. 1).

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Figure 1.

Overall rate of hormone therapy prescribing. Annual (January- December) prevalence (women on hormone therapy) and incidence (women new to hormone therapy) shown as percentage of all eligible women 50 years and older. Incidence was calculated for 2001 using data from 2000; therefore, incidence data do not exist for year 2000.

HT Use by Formulation

The prevalence of oral HT, the historically predominant formulation, declined from 19.0% in 2000 to 4.8% in 2009. In contrast, we observed an increase in the prevalence of vaginal formulations from 2.1% in 2000 to 3.3% in 2009 (Figure 2). The incidence of vaginal formulations also increased from 0.9% in 2001 to 1.7% in 2009, whereas the incidence of oral formulations declined from 4.3% in 2001 to 1.1% in 2009. By 2006, vaginal HT became the most predominant formulation for women initiating therapy. The prevalence and incidence of transdermal formulations remained relatively stable throughout the 10-year period (Fig. 2).

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Figure 2.

Prevalence and incidence of hormone therapy by formulation. Annual (January-December) prevalence of women using hormone therapy by formulation and incidence of women starting hormone therapy by formulation shown as a percentage of all eligible women 50 years and older.

HT Use by Dose

The prevalence of women prescribed high-dose oral HT declined from 2.8% in 2000 to 0.5% in 2009. The prevalence of standard doses also declined from 13.8% in 2000 to l.9% in 2009, with the sharpest change occurring between 2002 and 2005. Conversely, the prevalence of women who were prescribed low doses remained relatively constant from 2.3% in 2000 to 2.5% in 2009 (Fig. 3).

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Figure 3.

Prevalence by dose. Annual (January-December) prevalence of women on oral hormone therapy by level of dose shown as a percentage of total eligible women 50 years and older.

Prescriber Specialty

During the decade of study, the prevalence of women who had HT prescribed by an FP/IM/GP physician fell sharply from 9.9% in 2000 to 2.9% in 2009. Prescribing by gynecologists fell less notably, dropping from 8.8% in 2000 to 5.3% in 2009 (see Figure, Supplemental Digital Content 3, These trends resulted in a shift in the proportion of women who were prescribed HT by FP/IM/GP physicians versus gynecologists. In 2000, 45.7% of women received HT prescriptions from FP/IM/GP physicians and 40.9% from gynecologists; by 2009, more than 60% of women received their HT from gynecologists (Fig. 4).

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Figure 4.

Percentage of all hormone therapy patients by prescriber specialty. Numbers for each year exceed 100% because of the inclusion of women who are prescribed hormone therapy by more than one prescriber. FP, Family Practice; IM, Internal Medicine; GP, General Practice.

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