Long-term compliance with hormonal replacement therapy: Experience of Siriraj menopause clinic.

ABSTRACT

A retrospective analysis of women who registered for treatment at Siriraj Menopause Clinic in the year 1995 was performed to assess long-term compliance with hormonal replacement therapy (HRT). There were 217 women who registered that year and all were followed up for the following four years. Of these 217 women, 195 commenced HRT and were divided into two groups. The first group of 1,105 women (natural menopause, N) comprised 25 menopause transition and 80 postmenopause cases. The second one of 91 women (surgical menopause, S) was the group who previously underwent total hysterectomy with bilateral salpingooophorectomy. The average age at first consultation in the N group was 52.1 + 6.5 year which was significantly higher than 46.7 + 7.7 year in the S group (P<0.0001). In the N group, compliance was 61.9% at 1 year and 56.1%, 50.4%, 43.8% at 2,3 and 4 years while in the S group compliance was 74.7% at 1 year and 64.8%, 58.2%, 47.2% at 4 years respectively. Compliance with HRT was not statistically different between both groups (P>0.05). Drop out cases were maximum in the first years in both groups and total drop out cases increased slowly and steadily every year for the next four years. Ages at first consultation of compliant and non compliant women in each group were also not statistically different (P>0.05). Long-term compliance with HRT in this study was comparable with previously reported data. Main reasons for non compliance at 4 years were breast symptoms including breast masses and mastalgia, abnormal vaginal bleeding or irregular menses, weight gain and skin problems including acne, melasma and hair loss. These problems are different from other reports. Factors affecting long-term compliance with HRT should be further studied especially in those women who have undergone a surgical menopause.