Hormone Replacement Therapy Prescription after Premature Surgical Menopause

Nisha Garg, Sadikah Behbehani, Heidi Kosiorek, Kosiorek H, Megan Wasson
Journal of Minimally Invasive Gynecology · 2020 · vol. 27(7) , pp. 1618–1623 · doi:10.1016/j.jmig.2020.03.002 · PMID:32173578 · W3011312471
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This paper examined the prescribing patterns of hormone replacement therapy following surgical menopause in women who had their ovaries removed before the natural age of menopause.

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Abstract

STUDY OBJECTIVE: To assess hormone replacement therapy (HRT) prescription pattern in patients undergoing premature surgical menopause on the basis of surgical indication. DESIGN: Retrospective cohort study. SETTING: Academic tertiary care center. PATIENTS: Surgically menopausal patients aged ≤45 years who underwent a minimally invasive hysterectomy with salpingo-oophorectomy. INTERVENTIONS: HRT prescription in the 6-week postoperative period. MEASUREMENTS AND MAIN RESULTS: A total of 63 patients met inclusion criteria. Of these, 52% (n = 33) were prescribed HRT in the 6-week postoperative period. Indications for surgical menopause included pelvic pain or endometriosis (31.7%), gynecologic malignancy (20.6%), BRCA gene mutation (17.4%), breast cancer (9.5%), Lynch syndrome (4.8%), and other (15.8%). In total, 80% of patients with pelvic pain, 25% with gynecologic malignancies, 45% with BRCA gene mutations, 33.3% with breast cancer, and 66.6% with Lynch syndrome used HRT postoperatively. In patients who used HRT postoperatively, 76% were offered preoperative HRT counseling. This is in contrast with those patients who did not use HRT postoperatively, of whom only 33% were offered HRT counseling (p <.001). Perioperative complications were not predictive of HRT use postoperatively. In patients who did not use HRT postoperatively, 13.3% used alternative nonhormonal therapy. CONCLUSION: In patients who underwent premature surgical menopause, 52% used HRT postoperatively. Patients with pelvic pain and Lynch syndrome were more likely to use HRT, whereas those with gynecologic or breast malignancies and BRCA gene mutations were less likely to use HRT. Preoperative HRT counseling was associated with postoperative HRT use.

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Condition tags

endometriosis

MeSH descriptors

Gynecologic Surgical Procedures Hormone Replacement Therapy Hormone Replacement Therapy Hormone Replacement Therapy Menopause, Premature Menopause, Premature Menopause, Premature Menopause, Premature Postoperative Complications Practice Patterns, Physicians' Adult Adult Breast Neoplasms Breast Neoplasms Breast Neoplasms Breast Neoplasms Cohort Studies Cohort Studies Endometriosis Endometriosis

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