Physician Survey on Menopause Management

Executive Summary - September 2007

One of the biggest health stories in the past decade broke in 2002 when the Women's Health Initiative (WHI) study results were announced. The study - which was conducted by the National Institutes of Health and looked at the effects of hormone therapy (HT), diet modification, and calcium and vitamin D supplementation on heart disease, fractures, and breast and colorectal cancer in 161,808 generally healthy postmenopausal women - ended prematurely because of unanticipated findings, and created fear and confusion about the risks and benefits of menopausal management.

Since the release of the estrogen-progestin trial results in 2002, and the estrogen-only trial results in 2006, much has been written about the WHI. Many organizations, patient groups and the media have worked to educate women on what the results mean and about the latest recommendations for managing menopausal symptoms. The complexity of the study and its findings has made for challenging reporting and has caused confusion not only among women, but also within the medical community and the media.

Five years later, The Hormone Foundation, has conducted a physician survey to gauge how the WHI impacts the practice of menopause management and to identify areas where the Foundation, and its parent organization, The Endocrine Society, may be able to support physicians and their patients on this important health issue.

The survey asked 400 physicians - endocrinologists, obstetrician/gynecologists, internal medicine, family/ general practitioners - a series of questions about the WHI study and hormone therapy, including changes in prescribing hormone therapy, the issues patients are concerned with, the level of confusion about HT, how much time doctors spend with their patients explaining the risks and benefits of HT, and physician opinions on the need for future education in this area. We also asked them to tell us how they were impacted after the 2002 and 2006 announcement to gauge any changes over time.

The survey results taught us a lot:

There is still a lot of confusion about the best way(s) to manage menopausal symptoms and there is still much work to be done to dispel this confusion.
The survey indicated that physicians individualize hormone therapy and carefully evaluate a woman's health history and her comfort level with the risks and benefits, and offer alternative deliveries and alternative therapies for the management of menopausal symptoms.
The results reinforced the importance of physicians' role in educating patients and the tools and approaches the Foundation can use to encourage dialogue between them to partner in the treatment decisions.
The survey confirmed the importance of the media as a source of health information for the public and the value in partnering with the media to keep women well-informed of their choices.

Menopause clinical research is a relatively young arena with new data coming out regularly. As the field evolves and clinical trials build on each other, new doors will open to new treatment approaches that make a difference in women's lives. During this time, the Foundation will continue to seek out and provide the most current and balanced information, while also developing innovative educational programs to support patients.

The Hormone Foundation, the public education affiliate of The Endocrine Society, is a leading source of hormone-related health information for the public, physicians, allied health professionals and the media. Its mission is to serve as a resource for the public by promoting the prevention, treatment and cure of hormone-related conditions through outreach and education. The physician survey on menopause management was conducted by Richard Day Research, with the support of Novogyne Pharmaceuticals, from April 16 through May 23, 2007, and overseen by the Foundation’s Women’s Health Task Force.