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When Stopping Hormone Therapy, Patients Listen to You More than You Might Think

Summary and Comment |
March 10, 2014

When Stopping Hormone Therapy, Patients Listen to You More than You Might Think

  1. Anne Moore, DNP, APRN, FAANP

Counseling should be a big part of advice about discontinuing HT.

  1. Anne Moore, DNP, APRN, FAANP

Most women using hormone therapy (HT) will elect to discontinue use at some point; however, the return of symptoms can be challenging for them as well as their clinicians. In a study designed to define the strategies used by women who successfully stop HT, a telephone survey was completed by 1358 women (age range, 45–70) enrolled in two large health plans. Participants had used estrogen during a 17-month period in 2005 and 2006 and were queried about their attempts to discontinue HT, menopausal symptoms, and depression. In all, 465 respondents successfully stopped HT and 337 attempted but were unable to stop during the study period.

Compared with women who were unable to discontinue HT, those who stopped made fewer attempts to do so, had used HT for a shorter duration, were more likely to consider menopause a natural event, and were more likely to express attitudes that favor HT discontinuation. A total of 44% of discontinuers stated that they decided to stop HT based on their clinician's advice, and 67% indicated that they decided to quit on their own because of such factors as fear of breast cancer, doctor's advice, side effects of HT, media reports, and lack of symptoms. Abrupt cessation was employed by 61% of successful quitters and 51% of unsuccessful quitters. Women who were unable to stop HT were more likely than successful quitters to report sleep difficulties (74% vs. 57%), fatigue (51% vs. 38%), mood swings/depression (51% vs. 34%), and headaches (31% vs. 23%) upon attempts at discontinuation and were more likely to describe these symptoms as bothersome.

Comment

With shared decision making and individualized guidance from their clinicians, some well-informed women opt for extended use of hormone therapy. For women who choose to — or must — stop HT, providing anticipatory guidance about symptom management and promoting a positive attitude can contribute to successful discontinuation.

  • Disclosures for Anne Moore, DNP, APRN, FAANP at time of publication Consultant / Advisory board Watson

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Reader Comments (1)

walter mcphee

about what I thought

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