Perceptions of and attitudes toward estrogen therapy among surgically menopausal women in Taiwan

Objective: To evaluate awareness of and attitudes toward estrogen therapy (ET) among surgically menopausal women in Taiwan. Design: We performed a retrospective analysis of 188 women who underwent hysterectomy with bilateral oophorectomy before menopause. Responses to a questionnaire included women's thoughts about 20 of the most common menopausal symptoms, whether they used ET, and their attitudes about taking ET. Results: Mean respondent age at surgery was 45.3 +/- 4.2 (SD) years; 59 women (31.4%) were either current or former users of ET. Vegetarians had a lower rate of ET use (9.5%) than omnivores (34.1%, P = 0.0239, chi(2) test). By multiple logistic regression, insomnia (P = 0.005), palpitations (P = 0.024), and cold sweats (P = 0.027) were the symptoms most associated with ET use. The prevalence rates of the 20 menopausal symptoms ranged from 48.9% to 85.6%. By factor analysis, the 20 symptoms were grouped into four clusters: psychological, vasomotor, genital, and somatic. Although ET can improve all 20 symptoms, the effect was superior for the vasomotor cluster (P < 0.0001, analysis of variance). Of the women, 154 (81.9%) were aware of ET, and their major sources of information about it were health professionals (48. 1 %) and the mass media (34.4%). Only 49.5% of the women regarded ET as necessary, and 50.4% of the women who had never used ET claimed that they would use it if their doctor could persuade them that its benefits outweighed its risks. Conclusions: Even though ET can significantly improve vasomotor symptoms, surgically menopausal women in Taiwan have a low rate of ET use.