Hormone therapy for the management of the menopause in Ecuador: Perception, use and knowledge among middle-aged women

Background. There is scant data on social and personal aspects related to the use of menopausal hormone therapy (HT) in Latin America. Objectives. To obtain information regarding menopausal HT, i.e. use, perception, level and sources of knowledge, and to determine factors affecting several of these issues among middle-aged women of Guayaquil, Ecuador. Design. A total of 349 women (nursing staff), aged 40 years or more, were included in the present cross-sectional study. Participants completed a structured questionnaire including details related to HT and the reasons for not using it, as well as demographic and psychosocial data. Results. Only 50.1% of women considered HT beneficial. Current and former HT use was low (1.7% and 14.3%, respectively) and mean HT duration among former users was short (mean ± standard deviation: 1.0 ± 1.4 years). Women responded that the main reasons for not using HT were being asymptomatic (49.0%), non-established menopause (30.4%) and physician's advice (27.2%). Only 28.9% of women considered having enough information regarding HT, whereas a high percentage (93.1%) indicated willingness to participate in educational sessions addressing this issue. For most of the women the main sources of information were physicians, educational sessions and television. Logistic regression analysis determined that women with lower income and HT information did not consider HT beneficial at a higher rate than their counterparts. Premenopausal women and those with lower income were more prone to never HT use. Age and professional level were found to be confounding factors. Conclusions. HT use in this population was low; hormonal status, economic income and level of HT information determined its use and benefit awareness.