Trends in oral and vaginally administered estrogen use among US women 50 years of age or older with commercial health insurance.

OBJECTIVE: We aimed to provide information through 2015 about use in the United States of estrogen products, including orally and vaginally administered products, in postmenopausal women. METHODS: We used prescription claims for US commercial health insurance to calculate, in women 50 years of age or older (n = 12,007,364), the age-standardized and age-specific annual prevalence of estrogen use, by formulation and route of administration, for the period 2006 through 2015. RESULTS: The age-standardized annual prevalence of a prescription claim for oral estrogens declined over time, from 83 per 1,000 women in 2007 to 42 per 1,000 women in 2015. The age-standardized annual prevalence of a prescription claim for vaginal estrogens peaked in 2011, at 42 per 1,000 women, before declining to 35 per 1,000 women in 2015. The age-standardized annual prevalence of a prescription claim for transdermal estrogen fluctuated between 15 and 17 per 1,000 women. In age groups under 65 years of age, annual prevalence rates for vaginal rings and inserts declined over the latter half of the study period. CONCLUSIONS: Analyses of US prescription claims data between 2006 and 2015 for women 50 years of age or older showed declining use of oral estrogen generally and vaginally administered estrogen products specifically in age groups less than 65 years of age.

The abuse of high dose estrogen/progestin combination drugs in delay of menstruation: the assumptions and practices of doctors, midwives and pharmacists in a Peruvian city.

The results are presented of a field study of the use of high dose Estrogen/Progestin combination drugs in Cusco, Peru, 1987. In Western countries the sale of these products is restricted. In the 1970s the use of high dose Estrogen/Progestin combination drugs as a hormonal pregnancy test was assumed to cause birth defects. Still these drugs have high sales data in Third World countries, where they are marketed for the treatment of menstrual disorders and for pregnancy diagnosis. A widespread misuse as abortifacient is assumed, although the abortive effect has never been proved. In this study 112 gynaecological consultations by doctors and 53 by midwives were observed. Seventeen health professionals and 26 salesmen in pharmacies were interviewed. It turned out that doctors and midwives prescribe high dose Estrogen/Progestin combination drugs to women whose periods are delayed. Of the consults 33% concerned this complaint. Women prefer "hindsight" birth control methods. Abortion is illegal. Under the cover of menstruation regulation or pregnancy diagnosis health professionals meet the wishes of women who search for an abortifacient. The products can easily be obtained without prescription. It is suggested that high dose Estrogen/Progestin combination drugs should be withdrawn from the market.